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Bill Published 2 Oct 2025 Department of Health and Social Care ↗ View on Parliament

Mental Health Act 2025 — Keeling schedules: Keeling Schedule showing amendments to be made to the Mental Health Act 1983 by the Mental Health Bill introduced into Parliament on 6 November 2024 and amended post report stage in the Lords

Parliament bill publication: Keeling schedules. Commons.

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↓ Keeling Schedule - 25 September 2025
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▤ Verbatim text from source document

Keeling Schedule showing amendments to be made to the Mental Health Act 1983 by the Mental
Health Bill [Lords], as amended in the Public Bill Committee in the House of Commons [Bill 272]. The
Keeling Schedule also includes two minor and technical Government amendments, to be considered
at Report Stage in the House of Commons, which are still subject to approval by the House. This
Schedule has been prepared by the Department of Health and Social Care to assist the reader in
reviewing the changes to the Act that the Bill would effect, and has been produced for illustrative
purposes only. While every effort has been made to ensure its accuracy, it has not been subject to
legal review and should not be relied on as such. The Department of Health and Social Care would be
grateful if readers notify it of any errors or omissions.

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Mental Health Act 1983
1983 Chapter 20

Part I
INTRODUCTORY APPLICATION OF ACT

1. Application of Act: “mental disorder”.
(1) The provisions of this Act shall have effect with respect to the reception, care and
treatment of mentally disordered patients, the management of their property and other
related matters.
(2) In this Act—
“autism” means a lifelong developmental disorder of the mind that affects how people
perceive, communicate and interact with others;
“learning disability” means a state of arrested or incomplete development of the mind
which includes significant impairment of intelligence;
“mental disorder” means any disorder or disability of the mind; and
“mentally disordered” shall be construed accordingly;
“psychiatric disorder” means mental disorder other than autism or learning disability;
and other expressions shall have the meanings assigned to them in section 145 below.
(2A) For the purposes of this Act, a person’s learning disability has “serious behavioural
consequences” if it is associated with abnormally aggressive or seriously irresponsible
conduct by the person.”
(2A) But a person with learning disability shall not be considered by reason of that
disability to be–
(a) suffering from mental disorder for the purposes of the provisions mentioned in
subsection (2B) below; or

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(b) requiring treatment in hospital for mental disorder for the purposes of sections 17E
and 50 to 53 below,
unless that disability is associated with abnormally aggressive or seriously irresponsible
conduct on his part.
(2B) The provisions are–
(a) sections 3, 7, 17A, 20 and 20A below;
(b) sections 35 to 38, 45A, 47, 48 and 51 below; and
(c) section 72(1)(b) and (c) and (4) below.
(3) Dependence on alcohol or drugs is not considered to be a disorder or disability of the
mind for the purposes of subsection (2) above.
(4) In subsection (2A) above, “learning disability” means a state of arrested or incomplete
development of the mind which includes significant impairment of intelligence and social
functioning. ]5

1A “Appropriate medical treatment”
In this Act—
(a) references to appropriate medical treatment, in relation to a person suffering from
mental disorder, are references to medical treatment which, taking into account the
nature and degree of the disorder and all other circumstances—
(i) has a reasonable prospect of alleviating, or preventing the worsening of, the
disorder or one or more of its symptoms or manifestations, and
(ii) is appropriate in the person’s case;
(b) references to medical treatment, in relation to mental disorder, are references to
medical treatment the purpose of which is to alleviate, or prevent a worsening of, the
disorder or one or more of its symptoms or manifestations.”

Part II

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COMPULSORY ADMISSION TO HOSPITAL AND GUARDIANSHIP

Procedure for hospital admission
2. Admission for assessment.
(1) A patient may be admitted to a hospital and detained there for the period allowed by
subsection (4) below in pursuance of an application (in this Act referred to as “an
application for admission for assessment”) made in accordance with subsections (2) and
(3) below.
(2) An application for admission for assessment may be made in respect of a patient on
the grounds that—
(a) he is suffering from mental disorder of a nature or degree which warrants the
detention of the patient in a hospital for assessment (or for assessment followed by
medical treatment) for at least a limited period; and
(b) serious harm may be caused to the health or safety of the patient or of another
person unless the patient is so detained; and
(c) given the nature, degree and likelihood of the harm, the patient ought to be so
detained.
(b) he ought to be so detained in the interests of his own health or safety or with a view
to the protection of other persons.
(3) An application for admission for assessment shall be founded on the written
recommendations in the prescribed form of two registered medical practitioners,
including in each case a statement that in the opinion of the practitioner the conditions
set out in subsection (2) above are complied with.
(4) Subject to the provisions of section 29(4) below, a patient admitted to hospital in
pursuance of an application for admission for assessment may be detained for a period
not exceeding 28 days beginning with the day on which he is admitted, but shall not be
detained after the expiration of that period unless before it has expired he has become
liable to be detained by virtue of a subsequent application, order or direction under the
following provisions of this Act.

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3. Admission for treatment.
(1) A patient may be admitted to a hospital and detained there for the period allowed by
the following provisions of this Act in pursuance of an application (in this Act referred to as
“an application for admission for treatment”) made in accordance with this section.
(2) An application for admission for treatment may be made in respect of a patient on the
grounds that—
(a) the patient is suffering from psychiatric disorder of a nature or degree which makes
it appropriate for the patient to receive medical treatment in a hospital,
(b) serious harm may be caused to the health or safety of the patient or of another
person unless the patient receives medical treatment,
(c) it is necessary, given the nature, degree and likelihood of the harm, for the patient to
receive medical treatment,
(d) the necessary treatment cannot be provided unless the patient is detained under
this Act, and
(e) appropriate medical treatment is available for the patient.
(a)he is suffering from mental disorder of a nature or degree which makes it
appropriate for him to receive medical treatment in a hospital; and
(b)…..
(c) it is necessary for the health or safety of the patient or for the protection of other
persons that he should receive such treatment and it cannot be provided unless he is
detained under this section; and
(d) appropriate medical treatment is available for him.
(3) An application for admission for treatment shall be founded on the written
recommendations in the prescribed form of two registered medical practitioners,
including in each case a statement that in the opinion of the practitioner the conditions
set out in subsection (2) above are complied with; and each such recommendation shall
include—

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(a) such particulars as may be prescribed of the grounds for that opinion so far as it
relates to the conditions set out in paragraphs (a) and (e) (d) of that subsection; and
(b) a statement of the reasons for that opinion so far as it relates to the conditions set
out in paragraph (b) to (d) (c )of that subsection, specifying whether other methods of
dealing with the patient are available and, if so, why they are not appropriate.
(4) In this Act, references to appropriate medical treatment, in relation to a person
suffering from mental disorder, are references to medical treatment which is appropriate
in his case, taking into account the nature and degree of the mental disorder and all other
circumstances of his case.

4. Admission for assessment in cases of emergency.
(1) In any case of urgent necessity, an application for admission for assessment may be
made in respect of a patient in accordance with the following provisions of this section,
and any application so made is in this Act referred to as “an emergency application”.
(2) An emergency application may be made either by an approved mental health
professional or by the patient’s nominated person the nearest relative of the patient; and
every such application shall include a statement that it is of urgent necessity for the
patient to be admitted and detained under section 2 above, and that compliance with the
provisions of this Part of this Act relating to applications under that section would involve
undesirable delay.
(3) An emergency application shall be sufficient in the first instance if founded on one of
the medical recommendations required by section 2 above, given, if practicable, by a
practitioner who has previous acquaintance with the patient and otherwise complying
with the requirements of section 12 below so far as applicable to a single
recommendation, and verifying the statement referred to in subsection (2) above.
(4) An emergency application shall cease to have effect on the expiration of a period of 72
hours from the time when the patient is admitted to the hospital unless—
(a) the second medical recommendation required by section 2 above is given and
received by the managers within that period; and

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(b) that recommendation and the recommendation referred to in subsection (3) above
together comply with all the requirements of section 12 below (other than the
requirement as to the time of signature of the second recommendation).
(5) In relation to an emergency application, section 11 below shall have effect as if in
subsection (5) of that section for the words “the period of 14 days ending with the date of
the application” there were substituted the words “the previous 24 hours”.

5. Application in respect of patient already in hospital.
(1) An application for the admission of a patient to a hospital may be made under this Part
of this Act notwithstanding that the patient is already an in-patient in that hospital or, in
the case of an application for admission for treatment that the patient is for the time being
liable to be detained in the hospital in pursuance of an application for admission for
assessment; and where an application is so made the patient shall be treated for the
purposes of this Part of this Act as if he had been admitted to the hospital at the time
when that application was received by the managers.
(2) If, in the case of a patient who is an in-patient in a hospital, it appears to the registered
medical practitioner or approved clinician in charge of the treatment of the patient that
an application ought to be made under this Part of this Act for the admission of the patient
to hospital, he may furnish to the managers a report in writing to that effect; and in any
such case the patient may be detained in the hospital for a period of 72 hours from the
time when the report is so furnished.
(3) The registered medical practitioner or approved clinician in charge of the treatment of
a patient in a hospital may nominate one (but not more than one) person to act for him
under subsection (2) above in his absence.
(3A) For the purposes of subsection (3) above–
(a) the registered medical practitioner may nominate another registered medical
practitioner, or an approved clinician, on the staff of the hospital; and
(b) the approved clinician may nominate another approved clinician, or a registered
medical practitioner, on the staff of the hospital.
(4) If, in the case of a patient who is receiving treatment for mental disorder as an in-
patient in a hospital, it appears to a nurse of the prescribed class—

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(a) that the patient is suffering from mental disorder to such a degree that serious harm
may be caused to the health or safety of the patient or of another person unless the
patient is immediately restrained from leaving the hospital; and
(a) that the patient is suffering from mental disorder to such a degree that it is
necessary for his health or safety or for the protection of others for him to be
immediately restrained from leaving the hospital;
(b) that it is not practicable to secure the immediate attendance of a practitioner or
clinician for the purpose of furnishing a report under subsection (2) above, the nurse
may record that fact in writing; and in that event the patient may be detained in the
hospital for a period of six hours from the time when that fact is so recorded or until the
earlier arrival at the place where the patient is detained of a practitioner or clinician
having power to furnish a report under that subsection.
(5) A record made under subsection (4) above shall be delivered by the nurse (or by a
person authorised by the nurse in that behalf) to the managers of the hospital as soon as
possible after it is made; and where a record is made under that subsection the period
mentioned in subsection (2) above shall begin at the time when it is made.
(6) The reference in subsection (1) above to an in-patient does not include an in-patient
who is liable to be detained in pursuance of an application under this Part of this Act or a
community patient and the references in subsections (2) and (4) above do not include an
in-patient who is liable to be detained in a hospital under this Part of this Act or a
community patient.
(7) In subsection (4) above “prescribed” means prescribed by an order made by the
Secretary of State.

6. Effect of application for admission.
(1)An application for the admission of a patient to a hospital under this Part of this Act,
duly completed in accordance with the provisions of this Part of this Act, shall be sufficient
authority for the applicant, or any person authorised by the applicant, to take the patient
and convey him to the hospital at any time within the following period, that is to say—
(a)in the case of an application other than an emergency application, the period of 14
days beginning with the date on which the patient was last examined by a registered

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medical practitioner before giving a medical recommendation for the purposes of the
application;
(b)in the case of an emergency application, the period of 24 hours beginning at the time
when the patient was examined by the practitioner giving the medical
recommendation which is referred to in section 4(3) above, or at the time when the
application is made, whichever is the earlier.
(2)Where a patient is admitted within the said period to the hospital specified in such an
application as is mentioned in subsection (1) above, or, being within that hospital, is
treated by virtue of section 5 above as if he had been so admitted, the application shall be
sufficient authority for the managers to detain the patient in the hospital in accordance
with the provisions of this Act.
(3)Any application for the admission of a patient under this Part of this Act which appears
to be duly made and to be founded on the necessary medical recommendations may be
acted upon without further proof of the signature or qualification of the person by whom
the application or any such medical recommendation is made or given or of any matter of
fact or opinion stated in it.
(4)Where a patient is admitted to a hospital in pursuance of an application for admission
for treatment, any previous application under this part of this Act by virtue of which he
was liable to be detained in a hospital or subject to guardianship shall cease to have
effect.

Guardianship
7. Application for guardianship.
(1) A patient who has attained the age of 16 years may be received into guardianship, for
the period allowed by the following provisions of this Act, in pursuance of an application
(in this Act referred to as “a guardianship application”) made in accordance with this
section.
(2). A guardianship application may be made in respect of a patient on the grounds that—
(a) the patient is suffering from—
(i) psychiatric disorder,

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(ii) autism, or
(iii) learning disability which has serious behavioural consequences,
of a nature or degree which warrants the patient’s reception into guardianship under
this section, and
(a)he is suffering from mental disorder, F1. . . of a nature or degree which warrants his
reception into guardianship under this section; and
(b)it is necessary in the interests of the welfare of the patient or for the protection of
other persons that the patient should be so received.
(3) A guardianship application shall be founded on the written recommendations in the
prescribed form of two registered medical practitioners, including in each case a
statement that in the opinion of the practitioner the conditions set out in subsection (2)
above are complied with; and each such recommendation shall include—
(a)such particulars as may be prescribed of the grounds for that opinion so far as it
relates to the conditions set out in paragraph (a) of that subsection; and
(b)a statement of the reasons for that opinion so far as it relates to the conditions set
out in paragraph (b) of that subsection.
(4) A guardianship application shall state the age of the patient or, if his exact age is not
known to the applicant, shall state (if it be the fact) that the patient is believed to have
attained the age of 16 years.
(5) The person named as guardian in a guardianship application may be either a local
social services authority or any other person (including the applicant himself); but a
guardianship application in which a person other than a local social services authority is
named as guardian shall be of no effect unless it is accepted on behalf of that person by
the local social services authority for the area in which he resides, and shall be
accompanied by a statement in writing by that person that he is willing to act as guardian.

8. Effect of guardianship application, etc.
(1) Where a guardianship application, duly made under the provisions of this Part of this
Act and forwarded to the local social services authority within the period allowed by
subsection (2) below is accepted by that authority, the application shall, subject to

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regulations made by the Secretary of State, confer on the authority or person named in
the application as guardian, to the exclusion of any other person—
(a) the power to require the patient to reside at a place specified by the authority or
person named as guardian;
(b) the power to require the patient to attend at places and times so specified for the
purpose of medical treatment, occupation, education or training;
(c) the power to require access to the patient to be given, at any place where the
patient is residing, to any registered medical practitioner, approved mental health
professional or other person so specified.
(2) The period within which a guardianship application is required for the purposes of this
section to be forwarded to the local social services authority is the period of 14 days
beginning with the date on which the patient was last examined by a registered medical
practitioner before giving a medical recommendation for the purposes of the application.
(3) A guardianship application which appears to be duly made and to be founded on the
necessary medical recommendations may be acted upon without further proof of the
signature or qualification of the person by whom the application or any such medical
recommendation is made or given, or of any matter of fact or opinion stated in the
application.
(4) If within the period of 14 days beginning with the day on which a guardianship
application has been accepted by the local social services authority the application, or any
medical recommendation given for the purposes of the application, is found to be in any
respect incorrect or defective, the application or recommendation may, within that period
and with the consent of that authority, be amended by the person by whom it was signed;
and upon such amendment being made the application or recommendation shall have
effect and shall be deemed to have had effect as if it had been originally made as so
amended.
(5) Where a patient is received into guardianship in pursuance of a guardianship
application, any previous application under this Part of this Act by virtue of which he was
subject to guardianship or liable to be detained in a hospital shall cease to have effect.

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9. Regulations as to guardianship.
(1) Subject to the provisions of this Part of this Act, the Secretary of State may make
regulations—
(a) for regulating the exercise by the guardians of patients received into guardianship
under this Part of this Act of their powers as such; and
(b) for imposing on such guardians, and upon local social services authorities in the
case of patients under the guardianship of persons other than local social services
authorities, such duties as he considers necessary or expedient in the interests of the
patients.
(2) Regulations under this section may in particular make provision for requiring the
patients to be visited, on such occasions or at such intervals as may be prescribed by the
regulations, on behalf of such local social services authorities as may be so prescribed,
and shall provide for the appointment, in the case of every patient subject to the
guardianship of a person other than a local social services authority, of a registered
medical practitioner to act as the nominated medical attendant of the patient.

10. Transfer of guardianship in case of death, incapacity, etc., of guardian.
(1) If any person (other than a local social services authority) who is the guardian of a
patient received into guardianship under this Part of this Act—
(a) dies; or
(b) gives notice in writing to the local social services authority that he desires to
relinquish the functions of guardian,
the guardianship of the patient shall thereupon vest in the local social services
authority, but without prejudice to any power to transfer the patient into the
guardianship of another person in pursuance of regulations under section 19
below.
(2) If any such person, not having given notice under subsection (1)(b) above, is
incapacitated by illness or any other cause from performing the functions of guardian of
the patient, those functions may, during his incapacity, be performed on his behalf by the
local social services authority or by any other person approved for the purposes by that
authority.

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(3) If it appears to the county court, upon application made by an approved mental health
professional acting on behalf of the local social services authority , that any person other
than a local social services authority having the guardianship of a patient received into
guardianship under this Part of this Act has performed his functions negligently or in a
manner contrary to the interests of the welfare of the patient, the court may order that the
guardianship of the patient be transferred to the local social services authority or to any
other person approved for the purpose by that authority.
(4) Where the guardianship of a patient is transferred to a local social services authority or
other person by or under this section, subsection (2)(c) of section 19 below shall apply as if
the patient had been transferred into the guardianship of that authority or person in
pursuance of regulations under that section.
(5)In this section “the local social services authority”, in relation to a person (other than a
local social services authority) who is the guardian of a patient, means the local social
services authority for the area in which that person resides (or resided immediately before
his death).

General provisions as to applications and recommendations
11. General provisions as to applications.
(1) Subject to the provisions of this section, an application for admission for assessment,
an application for admission for treatment and a guardianship application may be made
either by the patient’s nominated person nearest relative of the patient or by an approved
mental health professional; and every such application shall specify the qualification of
the applicant to make the application.
(1A) No application mentioned in subsection (1) above shall be made by an approved
mental health professional if the circumstances are such that there would be a potential
conflict of interest for the purposes of regulations under section 12A below.
(2) Every application for admission shall be addressed to the managers of the hospital to
which admission is sought and every guardianship application shall be forwarded to the
local social services authority named in the application as guardian, or, as the case may
be, to the local social services authority for the area in which the person so named resides.
(3) Before or within a reasonable time after an application for the admission of a patient
for assessment is made by an approved mental health professional, that professional shall

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take such steps as are practicable to inform the person (if any) appearing to be the
patient’s nominated person the nearest relative of the patient that the application is to be
or has been made and of the power of the nominated person the nearest relative under
section 23(2)(a) below.
(4) Before an approved mental health professional makes an application for admission for
treatment or a guardianship application in respect of a patient who appears to have a
nominated person, the professional must consult that person.
(4) An approved mental health professional may not make an application for admission
for treatment or a guardianship application in respect of a patient in either of the
following cases–
(a) the nearest relative of the patient has notified that professional, or the local social
services authority on whose behalf the professional is acting, that he objects to the
application being made; or
(b) that professional has not consulted the person (if any) appearing to be the nearest
relative of the patient, but the requirement to consult that person does not apply if it
appears to the professional that in the circumstances such consultation is not reasonably
practicable or would involve unreasonable delay.
(4A) But the consultation requirement imposed by subsection (4) does not apply if it
appears to the approved mental health professional that consultation—
(a) is not reasonably practicable, or
(b) would involve unreasonable delay.
(4B) A patient’s nominated person may object to the making of an application for
admission for treatment or the making of a guardianship application by an approved
mental health professional by—
(a) notifying the professional, or
(b) notifying the local social services authority on whose behalf the professional is
acting.
(4C) Where a nominated person objects under subsection (4B) to the making of an
application, the application may be made only if it is accompanied by a report certifying
that, in the opinion of the approved mental health professional, the patient, if not

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admitted for treatment or received into guardianship, would be likely to act in a manner
that is dangerous to other persons or to the patient.
(5) None of the applications mentioned in subsection (1) above shall be made by any
person in respect of a patient unless that person has personally seen the patient within
the period of 14 days ending with the date of the application.
[subsection (6) was repealed by the Mental Health Act 2007]
(7) Each of the applications mentioned in subsection (1) above shall be sufficient if the
recommendations on which it is founded are given either as separate recommendations,
each signed by a registered medical practitioner, or as a joint recommendation signed by
two such practitioners.

12 General provisions as to medical recommendations.
(1) The recommendations required for the purposes of an application for the admission of
a patient under this Part of this Act or a guardianship application (in this Act referred to as
“medical recommendations”) shall be signed on or before the date of the application, and
shall be given by practitioners who have personally examined the patient either together
or separately, but where they have examined the patient separately not more than five
days must have elapsed between the days on which the separate examinations took
place.
(2) Of the medical recommendations given for the purposes of any such application, one
shall be given by a practitioner approved for the purposes of this section by the Secretary
of State as having special experience in the diagnosis or treatment of mental disorder; and
unless that practitioner has previous acquaintance with the patient, the other such
recommendation shall, if practicable, be given by a registered medical practitioner who
has such previous acquaintance.
(2A) A registered medical practitioner who is an approved clinician shall be treated as also
approved for the purposes of this section under subsection (2) above as having special
experience as mentioned there.
(3) No medical recommendation shall be given for the purposes of an application
mentioned in subsection (1) above if the circumstances are such that there would be a
potential conflict of interest for the purposes of regulations under section 12A below.

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12ZA. Agreement for exercise of approval function: England
(1) The Secretary of State may enter into an agreement with another person for an
approval function of the Secretary of State to be exercisable by the Secretary of State
concurrently—
(a) with that other person, and
(b) if a requirement under section 12ZB has effect, with the other person by whom the
function is exercisable under that requirement.
(2)In this section and sections 12ZB and 12ZC, “approval function” means—
(a) the function under section 12(2), or
(b) the function of approving persons as approved clinicians.
(3) An agreement under this section may, in particular, provide for an approval function to
be exercisable by the other party—
(a) in all circumstances or only in specified circumstances;
(b) in all areas or only in specified areas.
(4) An agreement under this section may provide for an approval function to be
exercisable by the other party—
(a) for a period specified in the agreement, or
(b) for a period determined in accordance with the agreement.
(5) The other party to an agreement under this section must comply with such instructions
as the Secretary of State may give with respect to the exercise of the approval function.
(6) An instruction under subsection (5) may require the other party to cease to exercise the
function to such extent as the instruction specifies.
(7) The agreement may provide for the Secretary of State to pay compensation to the
other party in the event of an instruction such as is mentioned in subsection (6) being
given.
(8) An instruction under subsection (5) may be given in such form as the Secretary of State
may determine.

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(9) The Secretary of State must publish instructions under subsection (5) in such form as
the Secretary of State may determine; but that does not apply to an instruction such as is
mentioned in subsection (6).
(10) An agreement under this section may provide for the Secretary of State to make
payments to the other party; and the Secretary of State may make payments to other
persons in connection with the exercise of an approval function by virtue of this section.

12ZB Requirement to exercise approval functions: England
(1) The Secretary of State may impose a requirement on NHS England “NHS England” or a
Special Health Authority for an approval function of the Secretary of State to be
exercisable by the Secretary of State concurrently—
(a) with NHS England or (as the case may be) Special Health Authority, and
(b) if an agreement under section 12ZA has effect, with the other person by whom the
function is exercisable under that agreement.
(2) The Secretary of State may, in particular, require the body concerned to exercise an
approval function—
(a) in all circumstances or only in specified circumstances;
(b) in all areas or only in specified areas.
(3) The Secretary of State may require the body concerned to exercise an approval
function—
(a) for a period specified in the requirement, or
(b) for a period determined in accordance with the requirement.
(4) Where a requirement under subsection (1) is imposed, NHS England or (as the case
may be) Special Health Authority must comply with such instructions as the Secretary of
State may give with respect to the exercise of the approval function.
(5) An instruction under subsection (4) may be given in such form as the Secretary of State
may determine.
(6) The Secretary of State must publish instructions under subsection (4) in such form as
the Secretary of State may determine.

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(7) Where NHS England or a Special Health Authority has an approval function by virtue of
this section, the function is to be treated for the purposes of the National Health Service
Act 2006 as a function that it has under that Act.
(8) The Secretary of State may make payments in connection with the exercise of an
approval function by virtue of this section.

12ZC. Provision of information for the purposes of section 12ZA or 12ZB
(1) A relevant person may provide another person with such information as the relevant
person considers necessary or appropriate for or in connection with—
(a) the exercise of an approval function; or
(b) the exercise by the Secretary of State of the power—
(i) to enter into an agreement under section 12ZA;
(ii) to impose a requirement under section 12ZB; or
(iii) to give an instruction under section 12ZA(5) or 12ZB(4).
(2) The relevant persons are—
(a) the Secretary of State;
(b) a person who is a party to an agreement under section 12ZA; or
(c) if the Secretary of State imposes a requirement under section 12ZB on NHS England
or a Special Health Authority, NHS England or (as the case may be) Special Health
Authority.
(3) This section, in so far as it authorises the provision of information by one relevant
person to another relevant person, has effect notwithstanding any rule of common law
which would otherwise prohibit or restrict the provision.
(4) In this section, “information” includes documents and records.

12A. Conflicts of interest
(1) The appropriate national authority may make regulations as to the circumstances in
which there would be a potential conflict of interest such that—

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(a) an approved mental health professional shall not make an application mentioned in
section 11(1) above;
(b) a registered medical practitioner shall not give a recommendation for the purposes
of an application mentioned in section 12(1) above.
(2) Regulations under subsection (1) above may make—
(a) provision for the prohibitions in paragraphs (a) and (b) of that subsection to be
subject to specified exceptions;
(b) different provision for different cases; and
(c) transitional, consequential, incidental or supplemental provision.
(3) In subsection (1) above, “ the appropriate national authority ” means—
(a) in relation to applications in which admission is sought to a hospital in England or to
guardianship applications in respect of which the area of the relevant local social
services authority is in England, the Secretary of State;
(b) in relation to applications in which admission is sought to a hospital in Wales or to
guardianship applications in respect of which the area of the relevant local social
services authority is in Wales, the Welsh Ministers.
(4) References in this section to the relevant local social services authority, in relation to a
guardianship application, are references to the local social services authority named in
the application as guardian or (as the case may be) the local social services authority for
the area in which the person so named resides.

13. Duty of approved mental health professionals to make applications for
admission or guardianship
(1) If a local social services authority have reason to think that an application for
admission to hospital or a guardianship application may need to be made in respect of a
patient within their area, they shall make arrangements for an approved mental health
professional to consider the patient's case on their behalf.
(1A) If that professional is–
(a) satisfied that such an application ought to be made in respect of the patient; and

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(b) of the opinion, having regard to any wishes expressed by relatives of the patient or
any other relevant circumstances, that it is necessary or proper for the application to
be made by him,
he shall make the application.
(1B) Subsection (1C) below applies where–
(a) a local social services authority makes arrangements under subsection (1) above in
respect of a patient;
(b) an application for admission for assessment is made under subsection (1A) above in
respect of the patient;
(c) while the patient is liable to be detained in pursuance of that application, the
authority have reason to think that an application for admission for treatment may
need to be made in respect of the patient; and
(d) the patient is not within the area of the authority.
(1C) Where this subsection applies, subsection (1) above shall be construed as requiring
the authority to make arrangements under that subsection in place of the authority
mentioned there.
(2) Before making an application for the admission of a patient to hospital an approved
mental health professional shall interview the patient in a suitable manner and satisfy
himself that detention in a hospital is in all the circumstances of the case the most
appropriate way of providing the care and medical treatment of which the patient stands
in need.
(3) An application under subsection (1A) above may be made outside the area of the local
social services authority on whose behalf the approved mental health professional is
considering the patient's case.
(4) It shall be the duty of a local social services authority, if so required by the nominated
person the nearest relative residing in their area, to make arrangements under subsection
(1) above for an approved mental health professional to consider the patient's case with a
view to making an application for his admission to hospital; and if in any such case that
professional decides not to make an application he shall inform the nominated person the
nearest relative of his reasons in writing.

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(5) Nothing in this section shall be construed as authorising or requiring an application to
be made by an approved mental health professional in contravention of the provisions of
section 11(4) above or of regulations under section 12A above, or as restricting the power
of a local social services authority to make arrangements with an approved mental health
professional to consider a patient's case or of an approved mental health professional to
make any application under this Act.

14. Social reports
Where a patient is admitted to a hospital in pursuance of an application (other than an
emergency application) made under this Part of this Act by his nominated person nearest
relative, the managers of the hospital shall as soon as practicable give notice of that fact
to the local social services authority for the area in which the patient resided immediately
before his admission; and that authority shall as soon as practicable arrange for an
approved mental health professional to interview the patient and provide the managers
with a report on his social circumstances.

15. Rectification of applications and recommendations.
(1) If within the period of 14 days beginning with the day on which a patient has been
admitted to a hospital in pursuance of an application for admission for assessment or for
treatment the application, or any medical recommendation given for the purposes of the
application, is found to be in any respect incorrect or defective, the application or
recommendation may, within that period and with the consent of the managers of the
hospital, be amended by the person by whom it was signed; and upon such amendment
being made the application or recommendation shall have effect and shall be deemed to
have had effect as if it had been originally made as so amended.
(2) Without prejudice to subsection (1) above, if within the period mentioned in that
subsection it appears to the managers of the hospital that one of the two medical
recommendations on which an application for the admission of a patient is founded is
insufficient to warrant the detention of the patient in pursuance of the application, they
may, within that period, give notice in writing to that effect to the applicant; and where
any such notice is given in respect of a medical recommendation, that recommendation
shall be disregarded, but the application shall be, and shall be deemed always to have
been, sufficient if—

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(a) a fresh medical recommendation complying with the relevant provisions of this Part
of this Act (other than the provisions relating to the time of signature and the interval
between examinations) is furnished to the managers within that period; and
(b) that recommendation, and the other recommendation on which the application is
founded, together comply with those provisions.
(3) Where the medical recommendations upon which an application for admission is
founded are, taken together, insufficient to warrant the detention of the patient in
pursuance of the application, a notice under subsection (2) above may be given in respect
of either of those recommendations.
(4) Nothing in this section shall be construed as authorising the giving of notice in respect
of an application made as an emergency application, or the detention of a patient
admitted in pursuance of such an application, after the period of 72 hours referred to in
section 4(4) above, unless the conditions set out in paragraphs (a) and (b) of that section
are complied with or would be complied with apart from any error or defect to which this
section applies.

Position of patients subject to detention or guardianship
[Section 16 was repealed by the Mental Health Act 2007]

17 Leave of absence from hospital.
(1) The responsible clinician may grant to any patient who is for the time being liable to be
detained in a hospital under this Part of this Act leave to be absent from the hospital
subject to such conditions (if any) a that clinician considers necessary in the interests of
the patient or for the protection of other persons.
(2) Leave of absence may be granted to a patient under this section either indefinitely or
on specified occasions or for any specified period; and where leave is so granted for a
specified period, that period may be extended by further leave granted in the absence of
the patient.
(2A) But longer-term leave may not be granted to a patient unless the responsible clinician
first considers whether the patient should be dealt with under section 17A instead.

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(2B)For these purposes, longer-term leave is granted to a patient if—
(a) leave of absence is granted to him under this section either indefinitely or for a
specified period of more than seven consecutive days; or
(b) a specified period is extended under this section such that the total period for which
leave of absence will have been granted to him under this section exceeds seven
consecutive days
(3) Where it appears to the responsible clinician that it is necessary so to do in the
interests of the patient or for the protection of other persons, he may, upon granting leave
of absence under this section, direct that the patient remain in custody during his
absence; and where leave of absence is so granted the patient may be kept in the custody
of any officer on the staff of the hospital, or of any other person authorised in writing by
the managers of the hospital or, if the patient is required in accordance with conditions
imposed on the grant of leave of absence to reside in another hospital, of any officer on
the staff of that other hospital.
(4) In any case where a patient is absent from a hospital in pursuance of leave of absence
granted under this section, and it appears to the responsible clinician that it is necessary
so to do in the interests of the patient’s health or safety or for the protection of other
persons, that clinician may, subject to subsection (5) below, by notice in writing given to
the patient or to the person for the time being in charge of the patient, revoke the leave of
absence and recall the patient to the hospital.
(5) A patient to whom leave of absence is granted under this section shall not be recalled
under subsection (4) above after he has ceased to be liable to be detained under this Part
of this Act;
(6) Subsection (7) below applies to a person who is granted leave by or by virtue of a
provision—
(a) in force in Scotland, Northern Ireland, any of the Channel Islands or the Isle of Man;
and
(b) corresponding to subsection (1) above.
(7) For the purpose of giving effect to a direction or condition imposed by virtue of a
provision corresponding to subsection (3) above, the person may be conveyed to a place
in, or kept in custody or detained at a place of safety in, England and Wales by a person
authorised in that behalf by the direction or condition.

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17A Community treatment orders
(1) The responsible clinician may by order in writing discharge a detained patient from
hospital subject to his being liable to recall in accordance with section 17E below.
(2) A detained patient is a patient who is liable to be detained in a hospital in pursuance of
an application for admission for treatment.
(3) An order under subsection (1) above is referred to in this Act as a “community
treatment order”.
(4) The responsible clinician may not make a community treatment order unless–
(a) in his opinion, the relevant criteria are met; and
(b) an approved mental health professional states in writing–
(i) that they agree that the relevant criteria are met; and
(ii) that it is appropriate to make the order; and
(c) where the responsible clinician is not the community clinician, the community
clinician states in writing that they agree that the relevant criteria are met.
(b) an approved mental health professional states in writing–
(i) that he agrees with that opinion; and
(ii) that it is appropriate to make the order–
(5) The relevant criteria are–
(a) the patient is suffering from psychiatric disorder of a nature or degree which makes
it appropriate for the patient to receive medical treatment,
(b) serious harm may be caused to the health or safety of the patient or of another
person unless the patient receives medical treatment,
(c) it is necessary, given the nature, degree and likelihood of the harm, for the patient to
receive medical treatment,
(d) subject to the patient being liable to be recalled as mentioned in paragraph (e), the
necessary treatment can be provided without the patient being detained in a hospital,

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(e) it is necessary that the responsible clinician should be able to exercise the power
under section 17E(1) to recall the patient to hospital, and
(f) appropriate medical treatment is available for the patient.
(a) the patient is suffering from mental disorder of a nature or degree which makes it
appropriate for him to receive medical treatment,
(b) it is necessary for his health or safety or for the protection of other persons that he
should receive such treatment;
(c) subject to his being liable to be recalled as mentioned in paragraph (d) below, such
treatment can be provided without his continuing to be detained in a hospital;
(d) it is necessary that the responsible clinician should be able to exercise the power
under section 17E(1) below to recall the patient to hospital; and
(e) appropriate medical treatment is available for him
(6) In determining whether the criterion in subsection (5)(e) (5)(d) above is met, the
responsible clinician shall, in particular, consider, having regard to the patient's history of
mental psychiatric disorder and any other relevant factors, what risk there would be of a
deterioration of the patient's condition if he were not detained in a hospital (as a result,
for example, of his refusing or neglecting to receive the medical treatment he requires for
his mental psychiatric disorder).
(7) In this Act–
“community patient” means a patient in respect of whom a community treatment
order is in force;
“the community treatment order” , in relation to such a patient, means the
community treatment order in force in respect of him; and
“the responsible hospital” , in relation to such a patient, means the hospital in
which he was liable to be detained immediately before the community treatment
order was made, subject to section 19A below.

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17AA Community treatment orders: role of nominated person
(1) Before the responsible clinician makes a community treatment order in respect of a
patient who appears to have a nominated person, the responsible clinician must consult
that person.
(2) But the consultation requirement imposed by subsection (1) does not apply if it
appears to the responsible clinician that consultation—
(a) is not reasonably practicable, or
(b) would involve unreasonable delay.
(3) A patient’s nominated person may object to the making of a community treatment
order by notifying the responsible clinician.
(4) Where the nominated person objects under subsection (3), the community treatment
order may not be made unless the responsible clinician certifies in writing that—
(a) in the opinion of the responsible clinician, the patient should be discharged from
hospital, and
(b) the patient, if so discharged without a community treatment order being in force,
would be likely to act in a manner that is dangerous to other persons or to the patient.

17B Conditions to be included in community treatment orders
(1) A community treatment order shall specify conditions to which the patient is to be
subject while the order remains in force.
(2) But, subject to subsection (3) below, the order may specify conditions only if the
responsible clinician, with the agreement of the relevant professionals approved mental
health professional mentioned in section 17A(4)(b) above, thinks them necessary or
appropriate for one or more of the following purposes–
(a) ensuring that the patient receives medical treatment;
(b) preventing risk of harm to the patient's health or safety;
(c) protecting other persons.

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(3) The order shall specify–
(a) a condition that the patient make himself available for examination under section
20A below; and
(b) a condition that, if it is proposed to give a certificate under Part 4A of this Act that
falls within section 64C(4) below in his case, he make himself available for examination
so as to enable the certificate to be given.
(4) The responsible clinician may from time to time by order in writing vary the conditions
specified in a community treatment order.
(5) He may also suspend any conditions specified in a community treatment order.
(5A) Where the responsible clinician is not the community clinician, the responsible
clinician must consult the community clinician before varying or suspending conditions
specified in a community treatment order, unless consultation would involve
unreasonable delay.
(6) If a community patient fails to comply with a condition specified in the community
treatment order by virtue of subsection (2) above, that fact may be taken into account for
the purposes of exercising the power of recall under section 17E(1) below.
(7) But nothing in this section restricts the exercise of that power to cases where there is
such a failure.
(8) In this section “the relevant professionals” means—
(a) the approved mental health professional making the statement required by section
17A(4)(b), and
(b) where section 17A(4)(c) applies, the community clinician.

17C Duration of community treatment order
A community treatment order shall remain in force until—
(a) the period mentioned in section 20A(1) below (as extended under any provision of
this Act) expires, but this is subject to sections 21 and 22 below;

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(b) the patient is discharged in pursuance of an order under section 23 below or a
direction under section 72 below;
(c) the application for admission for treatment in respect of the patient otherwise
ceases to have effect; or
(d) the order is revoked under section 17F below, whichever occurs first.

17D Effect of community treatment order
(1) The application for admission for treatment in respect of a patient shall not cease to
have effect by virtue of his becoming a community patient.
(2) But while he remains a community patient—
(a) the authority of the managers to detain him under section 6(2) above in pursuance
of that application shall be suspended; and
(b) reference (however expressed) in this or any other Act, or in any subordinate
legislation (within the meaning of the Interpretation Act 1978), to patients liable to be
detained, or detained, under this Act shall not include him.
(3) And section 20 below shall not apply to him while he remains a community patient.
(4) Accordingly, authority for his detention shall not expire during any period in which that
authority is suspended by virtue of subsection (2)(a) above.

17E Power to recall to hospital
(1) The responsible clinician may recall a community patient to hospital if in his opinion–
(a) the patient requires medical treatment in hospital for his psychiatric mental
disorder; and
(b) there would be a risk of harm to the health or safety of the patient or to other
persons if the patient were not recalled to hospital for that purpose.
(2) The responsible clinician may also recall a community patient to hospital if the patient
fails to comply with a condition specified under section 17B(3) above.

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(2A) Where the responsible clinician is not the community clinician, the responsible
clinician must consult the community clinician before recalling a community patient to
hospital, unless consultation would involve unreasonable delay.
(3) The hospital to which a patient is recalled need not be the responsible hospital.
(4) Nothing in this section prevents a patient from being recalled to a hospital even
though he is already in the hospital at the time when the power of recall is exercised;
references to recalling him shall be construed accordingly.
(5) The power of recall under subsections (1) and (2) above shall be exercisable by notice
in writing to the patient.
(6) A notice under this section recalling a patient to hospital shall be sufficient authority
for the managers of that hospital to detain the patient there in accordance with the
provisions of this Act.

17F Powers in respect of recalled patients
(1) This section applies to a community patient who is detained in a hospital by virtue of a
notice recalling him there under section 17E above.
(2) The patient may be transferred to another hospital in such circumstances and subject
to such conditions as may be prescribed in regulations made by the Secretary of State (if
the hospital in which the patient is detained is in England) or the Welsh Ministers (if that
hospital is in Wales).
(3) If he is so transferred to another hospital, he shall be treated for the purposes of this
section (and section 17E above) as if the notice under that section were a notice recalling
him to that other hospital and as if he had been detained there from the time when his
detention in hospital by virtue of the notice first began.
(4) The responsible clinician may by order in writing revoke the community treatment
order if–
(a) in his opinion, the conditions mentioned in section 3(2) above are satisfied in
respect of the patient; and
(b) an approved mental health professional states in writing–

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(i) that he agrees with that opinion; and
(ii) that it is appropriate to revoke the order.
(4A) Where the responsible clinician is not the community clinician, the responsible
clinician must consult the community clinician before revoking a community treatment
order, unless consultation would involve unreasonable delay.
(5) The responsible clinician may at any time release the patient under this section, but
not after the community treatment order has been revoked.
(6) If the patient has not been released, nor the community treatment order revoked, by
the end of the period of 72 hours, he shall then be released.
(7) But a patient who is released under this section remains subject to the community
treatment order.
(8) In this section–
(a) “the period of 72 hours” means the period of 72 hours beginning with the time when
the patient's detention in hospital by virtue of the notice under section 17E above
begins; and
(b) references to being released shall be construed as references to being released from
that detention (and accordingly from being recalled to hospital).

17G. Effect of revoking community treatment order
(1) This section applies if a community treatment order is revoked under section 17F
above in respect of a patient.
(2) Section 6(2) above shall have effect as if the patient had never been discharged from
hospital by virtue of the community treatment order.
(3) The provisions of this or any other Act relating to patients liable to be detained (or
detained) in pursuance of an application for admission for treatment shall apply to the
patient as they did before the community treatment order was made, unless otherwise
provided.

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(4) If, when the order is revoked, the patient is being detained in a hospital other than the
responsible hospital, the provisions of this Part of this Act shall have effect as if–
(a) the application for admission for treatment in respect of him were an application
for admission to that other hospital; and
(b) he had been admitted to that other hospital at the time when he was originally
admitted in pursuance of the application.
(5) But, in any case, section 20 and section 68 below shall have effect as if the patient had
been admitted to hospital in pursuance of the application for admission for treatment on
the day on which the order is revoked.

18. Return and readmission of patients absent without leave.
(1) Where a patient who is for the time being liable to be detained under this Part of this
Act in a hospital—
(a) absents himself from the hospital without leave granted under section 17 above; or
(b) fails to return to the hospital on any occasion on which, or at the expiration of any
period for which, leave of absence was granted to him under that section, or upon
being recalled under that section; or
(c) absents himself without permission from any place where he is required to reside in
accordance with conditions imposed on the grant of leave of absence under that
section,
he may, subject to the provisions of this section, be taken into custody and returned to the
hospital or place by any approved mental health professional, by any officer on the staff of
the hospital, by any constable, or by any person authorised in writing by the managers of
the hospital.
(2) Where the place referred to in paragraph (c) of subsection (1) above is a hospital other
than the one in which the patient is for the time being liable to be detained, the references
in that subsection to an officer on the staff of the hospital and the managers of the
hospital shall respectively include references to an officer on the staff of the first-
mentioned hospital and the managers of that hospital.
(2A) Where a community patient is at any time absent from a hospital to which he is
recalled under section 17E above, he may, subject to the provisions of this section, be

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taken into custody and returned to the hospital by any approved mental health
professional, by any officer on the staff of the hospital, by any constable, or by any person
authorised in writing by the responsible clinician or the managers of the hospital
(3) Where a patient who is for the time being subject to guardianship under this Part of this
Act absents himself without the leave of the guardian from the place at which he is
required by the guardian to reside, he may, subject to the provisions of this section, be
taken into custody and returned to that place by any officer on the staff of a local social
services authority, by any constable, or by any person authorised in writing by the
guardian or a local social services authority.
(4) A patient shall not be taken into custody under this section after the later of—
(a) the end of the period of six months beginning with the first day of his absence
without leave; and
(b) the end of the period for which (apart from section 21 below) he is liable to be
detained or subject to guardianship or, in the case of a community patient, the
community treatment order is in force;
(4A) In determining for the purposes of subsection (4)(b) above or any other provision of
this Act whether a person who is or has been absent without leave is at any time liable to
be detained or subject to guardianship, a report furnished under section 20 or 21B below
before the first day of his absence without leave shall not be taken to have renewed the
authority for his detention or guardianship unless the period of renewal began before that
day.
(4B) Similarly, in determining for those purposes whether a community treatment order is
at any time in force in respect of a person who is or has been absent without leave, a
report furnished under section 20A or 21B below before the first day of his absence
without leave shall not be taken to have extended the community treatment period unless
the extension began before that day.
(5) A patient shall not be taken into custody under this section if the period for which he is
liable to be detained is that specified in section 2(4), 4(4) or 5(2) or (4) above and that
period has expired.
(6) In this Act “absent without leave” means absent from any hospital or other place and
liable to be taken into custody and returned under this section, and related expressions
shall be construed accordingly.

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(7) In relation to a patient who has yet to comply with a requirement imposed by virtue of
this Act to be in a hospital or place, references in this Act to his liability to be returned to
the hospital or place shall include his liability to be taken to that hospital or place; and
related expressions shall be construed accordingly.

19. Regulations as to transfer of patients.
(1) In such circumstances and subject to such conditions as may be prescribed by
regulations made by the Secretary of State—
(a) a patient who is for the time being liable to be detained in a hospital by virtue of an
application under this Part of this Act may be transferred to another hospital or into
the guardianship of a local social services authority or of any person approved by
such an authority;
(b) a patient who is for the time being subject to the guardianship of a local social
services authority or other person by virtue of an application under this Part of this
Act may be transferred into the guardianship of another local social services
authority or person, or be transferred to a hospital.
(2) Where a patient is transferred in pursuance of regulations under this section, the
provisions of this Part of this Act (including this subsection) shall apply to him as follows,
that is to say—
(a) in the case of a patient who is liable to be detained in a hospital by virtue of an
application for admission for assessment or for treatment and is transferred to another
hospital, as if the application were an application for admission to that other hospital
and as if the patient had been admitted to that other hospital at the time when he was
originally admitted in pursuance of the application;
(b) in the case of a patient who is liable to be detained in a hospital by virtue of such an
application and is transferred into guardianship, as if the application were a
guardianship application duly accepted at the said time;
(c) in the case of a patient who is subject to guardianship by virtue of a guardianship
application and is transferred into the guardianship of another authority or person, as if
the application were for his reception into the guardianship of that authority or person
and had been accepted at the time when it was originally accepted;

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(d) in the case of a patient who is subject to guardianship by virtue of a guardianship
application and is transferred to a hospital, as if the guardianship application were an
application for admission to that hospital for treatment and as if the patient had been
admitted to the hospital at the time when the application was originally accepted.
(2A) But, in the case of a patient falling within subsection (2)(d), section 20 and section 68
have effect as if the patient had been admitted to hospital in pursuance of an application
for admission for treatment on the day on which the patient is transferred.
(3) Without prejudice to subsections (1) and (2) above, any patient, who is for the time
being liable to be detained under this Part of this Act in a hospital vested in the Secretary
of State for the purposes of his functions under the National Health Service Act 2006, in a
hospital vested in the Welsh Ministers for the purposes of their functions under the
National Health Service (Wales) Act 2006, in any accommodation used under either of
those Acts by the managers of such a hospital or in a hospital vested in a National Health
Service trust, NHS foundation trust or Local Health Board, may at any time be removed to
any other such hospital or accommodation which is managed by the managers of, or is
vested in the National Health Service trust, NHS foundation trust or Local Health Board or,
the first-mentioned hospital; and paragraph (a) of subsection (2) above shall apply in
relation to a patient so removed as it applies in relation to a patient transferred in
pursuance of regulations made under this section.
(3A) Before deciding to transfer a patient between hospitals in pursuance of regulations
under subsection (1), or in pursuance of subsection (3), the person responsible for taking
that decision must consult the patient’s nominated person (if any), unless consultation—
(a) is not reasonably practicable, or
(b) would involve unreasonable delay.
(4) Regulations made under this section may make provisions for regulating the
conveyance to their destination of patients authorised to be transferred or removed in
pursuance of the regulations or under subsection (3) above.

19A. Regulations as to assignment of responsibility for community patients
(1) Responsibility for a community patient may be assigned to another hospital in such
circumstances and subject to such conditions as may be prescribed by regulations made

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by the Secretary of State (if the responsible hospital is in England) or the Welsh Ministers
(if that hospital is in Wales).
(2) If responsibility for a community patient is assigned to another hospital—
(a) the application for admission for treatment in respect of the patient shall have
effect (subject to section 17D above) as if it had always specified that other hospital;
(b) the patient shall be treated as if he had been admitted to that other hospital at the
time when he was originally admitted in pursuance of the application (and as if he had
subsequently been discharged under section 17A above from there); and
(c) that other hospital shall become “the responsible hospital” in relation to the patient
for the purposes of this Act

Duration of authority and discharge
20. Duration of authority.
(1) Subject to the following provisions of this Part—
(a) a patient admitted to hospital in pursuance of an application for admission for
treatment may be detained in a hospital for a period not exceeding three months
beginning with the day on which the patient was so admitted, but may not be so
detained for any longer period unless the authority for the patient’s detention is
renewed under this section;
(b) a patient placed under guardianship in pursuance of a guardianship application
may be kept under guardianship for a period not exceeding six months beginning with
the day on which the guardianship application was accepted, but may not be so kept
for any longer period unless the authority for the patient’s guardianship is renewed
under this section.
(2) Authority for the detention of a patient may, unless the patient has previously been
discharged under section 23, be renewed—
(a) from the expiration of the period referred to in subsection (1)(a), for a further period
of three months;

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(b) from the expiration of any period of renewal under paragraph (a), for a further
period of six months;
(c) from the expiration of any period of renewal under paragraph (b), for a further
period of one year, and so on for periods of one year at a time.
(2A) Authority for the guardianship of a patient may, unless the patient has previously
been discharged under section 23, be renewed—
(a) from the expiration of the period referred to in subsection (1)(b), for a further period
of six months;
(b) from the expiration of any period of renewal under paragraph (a), for a further
period of one year, and so on for periods of one year at a time.
(1) Subject to the following provisions of this Part of this Act, a patient admitted to
hospital in pursuance of an application for admission for treatment, and a patient placed
under guardianship in pursuance of a guardianship application, may be detained in a
hospital or kept under guardianship for a period not exceeding six months beginning with
the day on which he was so admitted, or the day on which the guardianship application
was accepted, as the case may be, but shall not be so detained or kept for any longer
period unless the authority for his detention or guardianship is renewed under this
section.
(2) Authority for the detention or guardianship of a patient may, unless the patient has
previously been discharged under section 23 below , be renewed—
(a) from the expiration of the period referred to in subsection (1) above, for a further
period of six months;
(b) from the expiration of any period of renewal under paragraph (a) above, for a
further period of one year, and so on for periods of one year at a time.
(3) Within the period of two months ending on the day on which a patient who is liable to
be detained in pursuance of an application for admission for treatment would cease under
this section to be so liable in default of the renewal of the authority for his detention, it
shall be the duty of the responsible clinician—
(a) to examine the patient; and

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(b) if it appears to him that the conditions set out in subsection (4) below are satisfied,
to furnish to the managers of the hospital where the patient is detained a report to
that effect in the prescribed form; and where such a report is furnished in respect
of a patient the managers shall, unless they discharge the patient under section 23
below , cause him to be informed.
(4) The conditions referred to in subsection (3) above are that—
(a) the patient is suffering from psychiatric disorder of a nature or degree which makes
it appropriate for the patient to receive medical treatment in a hospital,
(b) serious harm may be caused to the health or safety of the patient or of another
person unless the patient receives medical treatment,
(c) it is necessary, given the nature, degree and likelihood of the harm, for the patient to
receive medical treatment,
(d) the necessary treatment cannot be provided unless the patient continues to be
liable to be detained, and
(e) appropriate medical treatment is available for the patient.
(a) the patient is suffering from mental disorder of a nature or degree which makes it
appropriate for him to receive medical treatment in a hospital,
(b) ……
(c) it is necessary for the health or safety of the patient or for the protection of other
persons that he should receive such treatment and that it cannot be provided unless he
continues to be detained; and
(d) appropriate medical treatment is available for him.
(5) Before furnishing a report under subsection (3) above the responsible clinician shall
consult one or more persons who have been professionally concerned with the patient’s
medical treatment—
(a) one or more other persons who have been professionally concerned with the
patient's medical treatment;
(b) if the patient appears to have a nominated person, the nominated person,

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(5A) But the responsible clinician may not furnish a report under subsection (3) above
unless a person–
(a) who has been professionally concerned with the patient's medical treatment; but

(b) who belongs to a profession other than that to which the responsible clinician
belongs, states in writing that he agrees that the conditions set out in subsection
(4) above are satisfied.
(6) Within the period of two months ending with the day on which a patient who is subject
to guardianship under this Part of this Act would cease under this section to be so liable in
default of the renewal of the authority for his guardianship, it shall be the duty of
the appropriate practitioner —
(a) to examine the patient; and

(b) if it appears to him that the conditions set out in subsection (7) below are satisfied,
to furnish to the guardian and, where the guardian is a person other than a local
social services authority, to the responsible local social services authority a report
to that effect in the prescribed form; and where such a report is furnished in
respect of a patient, the local social services authority shall, unless they discharge
the patient under section 23 below, cause him to be informed.
(6A) Before furnishing a report under subsection (6), the appropriate practitioner must, if
the patient appears to have a nominated person, consult that person.
(7) The conditions referred to in subsection (6) above are that—
(a) the patient is suffering from—
(i) psychiatric disorder,
(ii) autism, or
(iii) learning disability which has serious behavioural consequences,

of a nature or degree which warrants the patient’s reception into guardianship,
and

(a) the patient is suffering from [mental disorder]10 of a nature or degree which
warrants his reception into guardianship; and

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(b) it is necessary in the interests of the welfare of the patient or for the protection of
other persons that the patient should remain under guardianship.
(8) Where a report is duly furnished under subsection (3) or (6) above, the authority for the
detention or guardianship of the patient shall be thereby renewed for the period
prescribed in that case by subsection (2) or (2A) above.

20A Community treatment period
(1) Subject to the provisions of this Part of this Act, a community treatment order shall
cease to be in force on expiry of the period of six months beginning with the day on which
it was made.
(2) That period is referred to in this Act as “the community treatment period”.
(3) The community treatment period may, unless the order has previously ceased to be in
force, be extended–
(a) from its expiration for a period of six months;
(b) from the expiration of any period of extension under paragraph (a) above for a
further period of one year, and so on for periods of one year at a time.
(4) Within the period of two months ending on the day on which the order would cease to
be in force in default of an extension under this section, it shall be the duty of the
responsible clinician–
(a) to examine the patient; and
(b) if it appears to him that the criteria in section 17A(5) are met conditions set out in
subsection (6) below are satisfied and if a statement under subsection (8) below is
made, has been made—
(i) under subsection (8), and
(ii) where the responsible clinician is not the community clinician, under subsection
(8A),

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to furnish to the managers of the responsible hospital a report to that effect in the
prescribed form.
(5) Where such a report is furnished in respect of the patient, the managers shall, unless
they discharge him under section 23 below, cause him to be informed.
(6) The conditions referred to in subsection (4) above are that–
(a) the patient is suffering from mental disorder of a nature or degree which makes it
appropriate for him to receive medical treatment;
(b) it is necessary for his health or safety or for the protection of other persons that he
should receive such treatment;
(c) subject to his continuing to be liable to be recalled as mentioned in paragraph (d)
below, such treatment can be provided without his being detained in a hospital;
(d) it is necessary that the responsible clinician should continue to be able to exercise
the power under section 17E(1) above to recall the patient to hospital; and
(e) appropriate medical treatment is available for him.
(7) Subsection (6) of section 17A applies for the purposes of subsection (4)(b) of this
section as it applies for the purposes of subsection (4)(a) of that section.
(7) In determining whether the criterion in subsection (6)(d) (6)(c) above is met, the
responsible clinician shall, in particular, consider, having regard to the patient's history of
mental disorder and any other relevant factors, what risk there would be of a
deterioration of the patient's condition if he were to continue not to be detained in a
hospital (as a result, for example, of his refusing or neglecting to receive the medical
treatment he requires for his mental disorder).
(8) The statement referred to in subsection (4)(b)(i) above is a statement in writing by an
approved mental health professional–
(a) that it appears to him that the criteria in section 17A(5) are met; conditions set out
in subsection (6) above are satisfied and
(b) that it is appropriate to extend the community treatment period.

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(8A) The statement referred to in subsection (4)(b)(ii) is a statement in writing by the
community clinician that it appears to the community clinician that the conditions set out
in subsection (6) are satisfied.
(8B) Before making a statement under subsection (8)(b) in respect of a patient who
appears to have a nominated person, the approved mental health professional must
consult the nominated person, unless consultation—
(a) is not reasonably practicable, or
(b) would involve unreasonable delay.”
(9) Before furnishing a report under subsection (4) above the responsible clinician shall
consult one or more other persons who have been professionally concerned with the
patient's medical treatment.
(10) Where a report is duly furnished under subsection (4) above, the community
treatment period shall be thereby extended for the period prescribed in that case by
subsection (3) above.

20B. Effect of expiry of community treatment order
(1) A community patient shall be deemed to be discharged absolutely from liability to
recall under this Part of this Act, and the application for admission for treatment cease to
have effect, on expiry of the community treatment order, if the order has not previously
ceased to be in force.
(2) For the purposes of subsection (1) above, a community treatment order expires on
expiry of the community treatment period as extended under this Part of this Act, but this
is subject to sections 21 and 22 below.

21. Special provisions as to patients absent without leave.
(1) Where a patient is absent without leave—
(a) on the day on which (apart from this section) he would cease to be liable to be
detained or subject to guardianship under this Part of this Act or, in the case of a
community patient, the community treatment order would cease to be in force; or

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(b) within the period of one week ending with that day,
he shall not cease to be so liable or subject, or the order shall not cease to be in force, until
the relevant time.
(2) For the purposes of subsection (1) above the relevant time—
(a) where the patient is taken into custody under section 18 above, is the end of the
period of one week beginning with the day on which he is returned to the hospital or
place where he ought to be;
(b) where the patient returns himself to the hospital or place where he ought to be
within the period during which he can be taken into custody under section 18 above, is
the end of the period of one week beginning with the day on which he so returns
himself; and
(c) otherwise, is the end of the period during which he can be taken into custody under
section 18 above.
(3) Where a patient is absent without leave on the day on which (apart from this section)
the managers would be required under section 68 below to refer the patient's case to the
appropriate tribunal, that requirement shall not apply unless and until—
(a) the patient is taken into custody under section 18 above and returned to the
hospital where he ought to be; or
(b) the patient returns himself to the hospital where he ought to be within the period
during which he can be taken into custody under section 18 above.
(4) Where a community patient is absent without leave on the day on which (apart from
this section) the 72-hour period mentioned in section 17F above would expire, that period
shall not expire until the end of the period of 72 hours beginning with the time when—
(a) the patient is taken into custody under section 18 above and returned to the
hospital where he ought to be; or
(b) the patient returns himself to the hospital where he ought to be within the period
during which he can be taken into custody under section 18 above.
(5) Any reference in this section, or in sections 21A to 22 below, to the time when a
community treatment order would cease, or would have ceased, to be in force shall be
construed as a reference to the time when it would cease, or would have ceased, to be in
force by reason only of the passage of time.

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21A. Patients who are taken into custody or return within 28 days.
(1) This section applies where a patient who is absent without leave is taken into custody
under section 18 above, or returns himself to the hospital or place where he ought to be,
not later than the end of the period of 28 days beginning with the first day of his absence
without leave.
(2) Where the period for which the patient is liable to be detained or subject to
guardianship is extended by section 21 above, any examination and report to be made
and furnished in respect of the patient under section 20(3) or (6) above may be made and
furnished within the period as so extended.
(3) Where the authority for the detention or guardianship of the patient is renewed by
virtue of subsection (2) above after the day on which (apart from section 21 above) that
authority would have expired, the renewal shall take effect as from that day.
(4)In the case of a community patient, where the period for which the community
treatment order is in force is extended by section 21 above, any examination and report to
be made and furnished in respect of the patient under section 20A(4) above may be made
and furnished within the period as so extended.
(5)Where the community treatment period is extended by virtue of subsection (4) above
after the day on which (apart from section 21 above) the order would have ceased to be in
force, the extension shall take effect as from that day

21B. Patients who are taken into custody or return after more than 28 days.
(1) This section applies where a patient who is absent without leave is taken into custody
under section 18 above, or returns himself to the hospital or place where he ought to be,
later than the end of the period of 28 days beginning with the first day of his absence
without leave.
(2) It shall be the duty of the appropriate practitioner , within the period of one week
beginning with the day on which the patient is returned or returns himself to the hospital
or place where he ought to be (his “return day”)—
(a) to examine the patient; and
(b) if it appears to him that the relevant conditions are satisfied, to furnish to the
appropriate body a report to that effect in the prescribed form;

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and where such a report is furnished in respect of the patient the appropriate body
shall cause him to be informed.
(3) Where the patient is liable to be detained or is a community patient (as opposed to
subject to guardianship), the appropriate practitioner shall, before furnishing a report
under subsection (2) above, consult—
(a) one or more other persons who have been professionally concerned with the
patient's medical treatment; and
(b) an approved mental health professional.
(4) Where–
(a) the patient would (apart from any renewal of the authority for his detention or
guardianship on or after his return day) be liable to be detained or subject to
guardianship after the end of the period of one week beginning with that day; or
(b) in the case of a community patient, the community treatment order would (apart
from any extension of the community treatment period on or after that day) be in force
after the end of that period,
he shall cease to be so liable or subject, or the community treatment period shall be
deemed to expire, at the end of that period unless a report is duly furnished in respect
of him under subsection (2) above.
(4A) If, in the case of a community patient, the community treatment order is revoked
under section 17F above during the period of one week beginning with his return day–
(a) subsections (2) and (4) above shall not apply; and
(b) any report already furnished in respect of him under subsection (2) above shall be of
no effect.
(5) Where the patient would (apart from section 21 above) have ceased to be liable to be
detained or subject to guardianship on or before the day on which a report is duly
furnished in respect of him under subsection (2) above, the report shall renew the
authority for his detention or guardianship for the period prescribed in that case by
section 20(2) or (2A) above.
(6) Where the authority for the detention or guardianship of the patient is renewed by
virtue of subsection (5) above—

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(a) the renewal shall take effect as from the day on which (apart from section 21 above
and that subsection the authority would have expired; and
(b) if (apart from this paragraph) the renewed authority would expire on or before the
day on which the report is furnished, the report shall further renew the authority, as
from the day on which it would expire, for the period prescribed in that case by section
20(2) or (2A) above.
(6A) In the case of a community patient, where the community treatment order would
(apart from section 21 above) have ceased to be in force on or before the day on which a
report is duly furnished in respect of him under subsection (2) above, the report shall
extend the community treatment period for the period prescribed in that case by section
20A(3) above.
(6B) Where the community treatment period is extended by virtue of subsection (6A)
above–
(a) the extension shall take effect as from the day on which (apart from section 21
above and that subsection) the order would have ceased to be in force; and
(b) if (apart from this paragraph) the period as so extended would expire on or before
the day on which the report is furnished, the report shall further extend that period, as
from the day on which it would expire, for the period prescribed in that case by section
20A(3) above.
(7) Where the authority for the detention or guardianship of the patient would expire
within the period of two months beginning with the day on which a report is duly
furnished in respect of him under subsection (2) above, the report shall, if it so provides,
have effect also as a report duly furnished under section 20(3) or (6) above; and the
reference in this subsection to authority includes any authority renewed under subsection
(5) above by the report.
(7A) In the case of a community patient, where the community treatment order would
(taking account of any extension under subsection (6A) above) cease to be in force within
the period of two months beginning with the day on which a report is duly furnished in
respect of him under subsection (2) above, the report shall, if it so provides, have effect
also as a report duly furnished under section 20A(4) above.
[Subsections (8) and (9) were repealed by the Mental Health Act 2007]
(10) In this section—

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“the appropriate body” means–
(a) in relation to a patient who is liable to be detained in a hospital, the managers of the
hospital;
(b) in relation to a patient who is subject to guardianship, the responsible local social
services authority;
(c) in relation to a community patient, the managers of the responsible hospital; and
“the relevant conditions” means–
(a) in relation to a patient who is liable to be detained in a hospital, the conditions set
out in subsection (4) of section 20 above;
(b) in relation to a patient who is subject to guardianship, the conditions set out in
subsection (7) of that section;
(c) in relation to a community patient, the conditions set out in section 20A(6) above.

22. Special provisions as to patients sentenced to imprisonment, etc.
(1) If—
(a) a qualifying patient is detained in custody in pursuance of any sentence or order
passed or made by a court in the United Kingdom (including an order committing or
remanding him in custody); and
(b) he is so detained for a period exceeding, or for successive periods exceeding in the
aggregate, six months,
the relevant application shall cease to have effect on expiry of that period.
(2) A patient is a qualifying patient for the purposes of this section if—
(a)he is liable to be detained by virtue of an application for admission for treatment;
(b)he is subject to guardianship by virtue of a guardianship application; or
(c)he is a community patient.
(3) “The relevant application”, in relation to a qualifying patient, means—

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(a)in the case of a patient who is subject to guardianship, the guardianship application
in respect of him;
(b)in any other case, the application for admission for treatment in respect of him.
(4) The remaining subsections of this section shall apply if a qualifying patient is detained
in custody as mentioned in subsection (1)(a) above but for a period not exceeding, or for
successive periods not exceeding in the aggregate, six months.
(5) If apart from this subsection—
(a)the patient would have ceased to be liable to be detained or subject to guardianship
by virtue of the relevant application on or before the day on which he is discharged
from custody; or
(b) in the case of a community patient, the community treatment order would have
ceased to be in force on or before that day,
he shall not cease and shall be deemed not to have ceased to be so liable or subject, or the
order shall not cease and shall be deemed not to have ceased to be in force, until the end
of that day.
(6) In any case (except as provided in subsection (8) below), sections 18, 21 and 21A above
shall apply in relation to the patient as if he had absented himself without leave on that
day.
(7) In its application by virtue of subsection (6) above section 18 above shall have effect as
if—
(a) in subsection (4) for the words from “later of” to the end there were substituted “
end of the period of 28 days beginning with the first day of his absence without leave”;
and
(b) subsections (4A) and (4B) were omitted.
(8) In relation to a community patient who was not recalled to hospital under section 17E
above at the time when his detention in custody began—
(a)section 18 above shall not apply; but

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(b)sections 21 and 21A above shall apply as if he had absented himself without leave on
the day on which he is discharged from custody and had returned himself as provided
in those sections on the last day of the period of 28 days beginning with that day.

23. Discharge of patients.
(1) Subject to the provisions of this section and section 25 below, a patient who is for the
time being liable to be detained or subject to guardianship under this Part of this Act shall
cease to be so liable or subject if an order in writing discharging him absolutely from
detention or guardianship is made in accordance with this section.
(1A) Subject to the provisions of this section and section 25 below, a community patient
shall cease to be liable to recall under this Part of this Act, and the application for
admission for treatment cease to have effect, if an order in writing discharging him from
such liability is made in accordance with this section.
(1B) An order under subsection (1) or (1A) above shall be referred to in this Act as “an order
for discharge”.
(2) An order for discharge may be made in respect of a patient—
(a) where the patient is liable to be detained in a hospital in pursuance of an
application for admission for assessment or for treatment by the responsible
clinician , by the managers or by the patient’s nominated person the nearest
relative of the patient.
(b) where the patient is subject to guardianship, by the responsible clinician , by
the responsible local social services authority or by the patient’s nominated person
the nearest relative of the patient.
(c) where the patient is a community patient, by the responsible clinician, by the
managers of the responsible hospital or by the patient’s nominated person the
nearest relative of the patient.
(2A) Before making an order for discharge by virtue of subsection (2)(a), the responsible
clinician must consult a person—
(a) who has been professionally concerned with the patient’s medical treatment,
and

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(b) who belongs to a profession other than that to which the responsible clinician
belongs.
(2B) Before making an order for discharge by virtue of subsection (2)(b)—
(a) the responsible clinician must consult a person—
(i) who has been professionally concerned with the patient’s care or
treatment, and
(ii) who belongs to a profession other than that to which the responsible
clinician belongs
(b) the responsible local social services authority must ensure that whoever is
taking the decision for the authority consults a person who has been professionally
concerned with the patient’s care or treatment (whether or not a member of staff
of the authority);
(c) the patient’s nominated person must consult the responsible local social
services authority.
(2C) Before making an order for discharge by virtue of subsection (2)(c)—
(a) the responsible clinician must, if they are not the community clinician, consult
the community clinician;
(b) the hospital managers must consult the community clinician.

(4) The powers conferred by this section on any authority trust (other than an NHS
foundation trust, board or body of persons may be exercised subject to subsection (5)
below by any three or more members of that authority trust, board or body authorised
by them in that behalf or by three or more members of a committee or sub-committee of
that authority trust, board or body which has been authorised by them in that behalf.
(5) The reference in subsection (4) above to the members of an authority, trust, board or
body or the members of a committee or sub-committee of an authority, trust, board or
body,—
(a) in the case of a Local Health Board or Special Health Authority or a committee or
sub-committee of a Local Health Board or Special Health Authority, is a reference

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only to the chairman of the authority or board and such members (of the authority,
board, committee or sub-committee , as the case may be) as are not also officers of
the authority or board, within the meaning of the National Health Service Act 2006
or the National Health Service (Wales) Act 2006; and

(b) in the case of a National Health Service trust or a committee or sub-committee of
such a trust, is a reference only to the chairman of the trust and such directors or
(in the case of a committee or sub-committee) members as are not also employees
of the trust.
(6) The powers conferred by this section on any NHS foundation trust may be exercised by
any three or more persons authorised by the board of the trust in that behalf each of
whom is neither an executive director of the board nor an employee of the trust.

24. Visiting and examination of patients.
(1) For the purpose of advising as to the exercise by the nominated person the nearest
relative of a patient who is liable to be detained or subject to guardianship under this Part
of this Act, or who is a community patient, of any power to order his discharge, any
registered medical practitioner or approved clinician authorised by or on behalf of the
nominated person the nearest relative of the patient may, at any reasonable time, visit the
patient and examine him in private.
(2) Any registered medical practitioner or approved clinician authorised for the purposes
of subsection (1) above to visit and examine a patient may require the production of and
inspect any records relating to the detention or treatment of the patient in any hospital or
to any after-care services provided for the patient under section 117 below.

25. Restrictions on discharge by nominated person nearest relative.
(1) An order for the discharge of a patient who is liable to be detained in a hospital shall
not be made under section 23 above by his nominated person nearest relative except
after giving not less than 72 hours' notice in writing to the managers of the hospital; and if,
within 72 hours after such notice has been given, the responsible clinician furnishes to the
managers a report certifying that in the opinion of that clinician the patient, if discharged,
would be likely to act in a manner dangerous to other persons or to himself—

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(a) any order for the discharge of the patient made by that nominated person relative in
pursuance of the notice shall be of no effect; and
(b) no further order for the discharge of the patient shall be made by that nominated
person relative during the period of three months six months beginning with the date
of the report.
(1A) Subsection (1) above shall apply to an order for the discharge of a community patient
as it applies to an order for the discharge of a patient who is liable to be detained in a
hospital, but with the reference to the managers of the hospital being read as a reference
to the managers of the responsible hospital.
(2) In any case where a report under subsection (1) above is furnished in respect of a
patient who is liable to be detained in pursuance of an application for admission for
treatment, or in respect of a community patient, the managers shall cause the nominated
person nearest relative of the patient to be informed.

[Sections 25A to 25J is not affected by the amendments to be made by the draft Mental
Health Bill and are not included in this Schedule]

Functions of relative of patients
26.— Definition of “relative” and “nearest relative”.
(1) In this Part of this Act “relative” means any of the following persons:—
(a) husband or wife [ or civil partner]1 ;
(b) son or daughter;
(c) father or mother;
(d) brother or sister;
(e) grandparent;
(f) grandchild;
(g) uncle or aunt;

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(h) nephew or niece.
(2) In deducing relationships for the purposes of this section, any relationship of the half-
blood shall be treated as a relationship of the whole blood, and an illegitimate person
shall be treated as the legitimate child of
(a) his mother, and
(b) if his father has parental responsibility for him within the meaning of section 3 of the
Children Act 1989, his father.
(3) In this Part of this Act, subject to the provisions of this section and to the following
provisions of this Part of this Act, the “nearest relative” means the person first described in
subsection (1) above who is for the time being surviving, relatives of the whole blood
being preferred to relatives of the same description of the half-blood and the elder or
eldest of two or more relatives described in any paragraph of that subsection being
preferred to the other or others of those relatives, regardless of sex.
(4) Subject to the provisions of this section and to the following provisions of this Part of
this Act, where the patient ordinarily resides with or is cared for by one or more of his
relatives (or, if he is for the time being an in-patient in a hospital, he last ordinarily resided
with or was cared for by one or more of his relatives) his nearest relative shall be
determined—
(a) by giving preference to that relative or those relatives over the other or others; and
(b) as between two or more such relatives, in accordance with subsection (3) above.
(5) Where the person who, under subsection (3) or (4) above, would be the nearest relative
of a patient—
(a) in the case of a patient ordinarily resident in the United Kingdom, the Channel
Islands or the Isle of Man, is not so resident; or
(b) is the husband or wife or civil partner of the patient, but is permanently separated
from the patient, either by agreement or under an order of a court, or has deserted or
has been deserted by the patient for a period which has not come to an end; or
(c) is a person other than the husband, wife, civil partner, father or mother of the
patient, and is for the time being under 18 years of age;
the nearest relative of the patient shall be ascertained as if that person were dead.

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(6) In this section “husband” , “wife” and “civil partner” include a person who is living with
the patient as the patient's husband or wife or as if they were civil partners , as the case
may be (or, if the patient is for the time being an in-patient in a hospital, was so living until
the patient was admitted), and has been or had been so living for a period of not less than
six months; but a person shall not be treated by virtue of this subsection as the nearest
relative of a married patient or a patient in a civil partnership unless the husband, wife or
civil partner of the patient is disregarded by virtue of paragraph (b) of subsection (5)
above.
(7) A person, other than a relative, with whom the patient ordinarily resides (or, if the
patient is for the time being an in-patient in a hospital, last ordinarily resided before he
was admitted), and with whom he has or had been ordinarily residing for a period of not
less than five years, shall be treated for the purposes of this Part of this Act as if he were a
relative but—
(a) shall be treated for the purposes of subsection (3) above as if mentioned last in
subsection (1) above; and
(b) shall not be treated by virtue of this subsection as the nearest relative of a married
patient [or a patient in a civil partnership unless the husband, wife or civil partner]8 of
the patient is disregarded by virtue of paragraph (b) of subsection (5) above.
27. Children and young persons in care.
Where—
(a) a patient who is a child or young person is in the care of a local authority by virtue of a
care order within the meaning of the Children Act 1989; or
(b) the rights and powers of a parent of a patient who is a child or young person are vested
in a local authority by virtue of section 16 of the Social Work (Scotland) Act 1968,
the authority shall be deemed to be the nearest relative of the patient in preference to any
person except the patient's husband or wife or civil partner (if any).

28.— Nearest relative of minor under guardianship, etc.
(1) Where—

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(a) a guardian has been appointed for a person who has not attained the age of
eighteen years; or
(b) a [person is named in a child arrangements]2 order (as defined by section 8 of the
Children Act 1989 ) [as a person with whom a person who has not attained the age of
eighteen years is to live]3 ,
the guardian (or guardians, where there is more than one) or the person [so named (or the
persons so named, where there is more than one)]4 shall, to the exclusion of any other
person, be deemed to be his nearest relative.
(2) Subsection (5) of section 26 above shall apply in relation to a person who is, or who is
one of the persons, deemed to be the nearest relative of a patient by virtue of this section
as it applies in relation to a person who would be the nearest relative under subsection (3)
of that section.
(3) In this section “guardian” does not include a guardian [ includes a special guardian
(within the meaning of the Children Act 1989), but]6 under this Part of this Act.
(4) In this section “court” includes a court in Scotland or Northern Ireland, and
“enactment” includes an enactment of the Parliament of Northern Ireland, a Measure of
the Northern Ireland Assembly and an Order in Council under Schedule 1 of the Northern
Ireland Act 1974.
29.— Appointment by court of acting nearest relative.
(1) The county court may, upon application made in accordance with the provisions of this
section in respect of a patient, by order direct that the functions of the nearest relative of
the patient under this Part of this Act and sections 66 and 69 below shall, during the
continuance in force of the order, be exercisable by the person specified in the order .
(1A) If the court decides to make an order on an application under subsection (1) above,
the following rules have effect for the purposes of specifying a person in the order–
(a) if a person is nominated in the application to act as the patient's nearest relative
and that person is, in the opinion of the court, a suitable person to act as such and is
willing to do so, the court shall specify that person (or, if there are two or more such
persons, such one of them as the court thinks fit);
(b) otherwise, the court shall specify such person as is, in its opinion, a suitable person
to act as the patient's nearest relative and is willing to do so.

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(2) An order under this section may be made on the application of—[
(za) the patient;
(a) any relative of the patient;
(b) any other person with whom the patient is residing (or, if the patient is then an in-
patient in a hospital, was last residing before he was admitted); or
(c) an approved mental health professional.
(3) An application for an order under this section may be made upon any of the following
grounds, that is to say—
(a) that the patient has no nearest relative within the meaning of this Act, or that it is
not reasonably practicable to ascertain whether he has such a relative, or who that
relative is;
(b) that the nearest relative of the patient is incapable of acting as such by reason of
mental disorder or other illness;
(c) that the nearest relative of the patient unreasonably objects to the making of an
application for admission for treatment or a guardianship application in respect of the
patient; [...]6
(d) that the nearest relative of the patient has exercised without due regard to the
welfare of the patient or the interests of the public his power to discharge the patient
[...]7 under this Part of this Act, or is likely to do so [; or]8
(e) that the nearest relative of the patient is otherwise not a suitable person to act as
such.
(4) If, immediately before the expiration of the period for which a patient is liable to be
detained by virtue of an application for admission for assessment, an application under
this section, which is an application made on the ground specified in subsection (3)(c) or
(d) above, is pending in respect of the patient, that period shall be extended—
(a) in any case, until the application under this section has been finally disposed of; and
(b) if an order is made in pursuance of the application under this section, for a further
period of seven days;

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and for the purposes of this subsection an application under this section shall be deemed
to have been finally disposed of at the expiration of the time allowed for appealing from
the decision of the court or, if notice of appeal has been given within that time, when the
appeal has been heard or withdrawn, and “pending” shall be construed accordingly.
(5) An order made on the ground specified in subsection (3)(a), (b) or (e) above may specify
a period for which it is to continue in force unless previously discharged under section 30
below.
(6) While an order made under this section is in force, the provisions of this Part of this Act
(other than this section and section 30 below) and sections 66, 69, 132(4) and 133 below
shall apply in relation to the patient as if for any reference to the nearest relative of the
patient there were substituted a reference to the person having the functions of that
relative and (without prejudice to section 30 below) shall so apply notwithstanding that
the person who was the patient's nearest relative when the order was made is no longer
his nearest relative; but this subsection shall not apply to section 66 below in the case
mentioned in paragraph (h) of subsection (1) of that section.
30.— Discharge and variation of orders under s. 29.
(1) An order made under section 29 above in respect of a patient may be discharged by the
county court upon application made—
(a) in any case, by [ the patient or]1 the person having the functions of the nearest
relative of the patient by virtue of the order;
(b) where the order was made on the ground specified in paragraph (a), (b) or (e) of
section 29(3) above, or where the person who was the nearest relative of the patient
when the order was made has ceased to be his nearest relative, on the application of
the nearest relative of the patient.
(1A) But, in the case of an order made on the ground specified in paragraph (e) of section
29(3) above, an application may not be made under subsection (1)(b) above by the person
who was the nearest relative of the patient when the order was made except with leave of
the county court.
(2) An order made under section 29 above in respect of a patient may be varied by the
county court, on the application of the person having the functions of the nearest relative
by virtue of the order or on the application of the patient or of an approved mental health
professional , by substituting another person for the person having those functions].

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(2A) If the court decides to vary an order on an application under subsection (2) above, the
following rules have effect for the purposes of substituting another person–
(a) if a person is nominated in the application to act as the patient's nearest relative and
that person is, in the opinion of the court, a suitable person to act as such and is willing to
do so, the court shall specify that person (or, if there are two or more such persons, such
one of them as the court thinks fit);
(b) otherwise, the court shall specify such person as is, in its opinion, a suitable person to
act as the patient's nearest relative and is willing to do so.
(3) If the person having the functions of the nearest relative of a patient by virtue of an
order under section 29 above dies—
(a) subsections (1) and (2) above shall apply as if for any reference to that person there
were substituted a reference to any relative of the patient, and
(b) until the order is discharged or varied under those provisions the functions of the
nearest relative under this Part of this Act and sections 66 and 69 below shall not be
exercisable by any person.
(4) An order made on the ground specified in paragraph (c) or (d) of section 29(3) above
shall, unless previously discharged under subsection (1) above, cease to have effect as
follows]8 —
(a) if–
(i) on the date of the order the patient was liable to be detained or subject to guardianship
by virtue of a relevant application, order or direction; or
(ii) he becomes so liable or subject within the period of three months beginning with that
date; or
(iii) he was a community patient on the date of the order,
it shall cease to have effect when he is discharged under section 23 above or 72 below or
the relevant application, order or direction otherwise ceases to have effect (except as a
result of his being transferred in pursuance of regulations under section 19 above);
(b) otherwise, it shall cease to have effect at the end of the period of three months
beginning with the date of the order.

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(4A) In subsection (4) above, reference to a relevant application, order or direction is to
any of the following–
(a) an application for admission for treatment;
(b) a guardianship application;
(c) an order or direction under Part 3 of this Act (other than under section 35, 36 or 38).
]10[
(4B) An order made on the ground specified in paragraph (a), (b) or (e) of section 29(3)
above shall–
(a) if a period was specified under section 29(5) above, cease to have effect on expiry of
that period, unless previously discharged under subsection (1) above;
(b) if no such period was specified, remain in force until it is discharged under subsection
(1) above.
(5) The discharge or variation under this section of an order made under section 29 above
shall not affect the validity of anything previously done in pursuance of the order.

[Sections 27 to 30 are not affected by the amendments to be made by the draft Mental
Health Bill and are not included in this Schedule]

Nominated personsappointment and removal
30A. Nominated person
Schedule A1—
(a) confers power to appoint a nominated person for a patient for the purposes of this
Act, and
(b) makes provision about the duration of an appointment of a nominated person.

30B. Power of court to terminate appointment of nominated person

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(1) The county court may, on an application made in accordance with the provisions of
this section, make an order terminating the appointment of a nominated person for a
patient.
(2) An order under this section may be made on the application of—
(a) the patient,
(b) an approved mental health professional, or
(c) any person engaged in caring for the patient or interested in the patient’s welfare.
(3) An application for an order under this section may only be made on the grounds that—
(a) the nominated person unreasonably objects to the making of an application for
admission for treatment or a guardianship application in respect of the patient;
(b) the nominated person has, without due regard to the welfare of the patient or the
interests of the public, exercised the power to discharge the patient under this Part of
this Act or is likely to do so;
(c) the nominated person unreasonably objects to the making of a community
treatment order in respect of the patient;
(d) the patient has done anything which is clearly inconsistent with the nominated
person remaining the patient’s nominated person;
(e) the nominated person lacks the capacity or competence to act as a nominated
person;
(f) the nominated person is otherwise not a suitable person to act as a nominated
person.
(4) If, immediately before the expiry of the period for which a patient is liable to be
detained by virtue of an application for admission for assessment, an application under
this section, which is an application made on the ground specified in subsection (3)(a) or
(b), is pending in respect of the patient, that period is extended—
(a) in any case, until the application under this section has been finally disposed of, and
(b) if an order is made in pursuance of the application under this section, for a further
period of seven days.

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(5) For the purposes of subsection (4)—
(a) an application under this section is “pending” until it is finally disposed of, and
(b)an application under this section is “finally disposed of”—
(i) when the time allowed for appealing against court’s decision expires without an
appeal being brought, or
(ii) where an appeal is brought within that time, when the appeal has been heard
or withdrawn.
(6) Where an order under this section terminates the appointment of a nominated person
for a patient, the person is disqualified from being re-appointed for the period specified by
the court in the order.
(7) In this section “patient” means—
(a) a person by whom a nominated person is appointed under Part 1 of Schedule
A1, or
(b) a person for whom a nominated person is appointed under Part 2 of that
Schedule.

Supplemental
31. Procedure on applications to county court.
Rules of court which relate to applications authorised by this Part of this Act to be made to
the county court may make provision—
(a) for the hearing and determination of such applications otherwise than in open
court;
(b) for the admission on the hearing of such applications of evidence of such
descriptions as may be specified in the rules notwithstanding anything to the contrary
in any enactment or rule of law relating to the admissibility of evidence;
(c) for the visiting and interviewing of patients in private by or under the directions of
the court.

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32. Regulations for purposes of Part II.
(1) The Secretary of State may make regulations for prescribing anything which, under this
Part of this Act, is required or authorised to be prescribed, and otherwise for carrying this
Part of this Act into full effect.
(2) Regulations under this section may in particular make provision—
(a) for prescribing the form of any application, recommendation, report, order, notice
or other document to be made or given under this Part of this Act;
(b) for prescribing the manner in which any such application, recommendation, report,
order, notice or other document may be proved, and for regulating the service of any
such application, report, order or notice;
(c) for requiring such bodies as may be so prescribed to keep such registers or other
records as may be prescribed by the regulations in respect of patients liable to be
detained or subject to guardianship under this Part of this Act or community patients,
and to furnish or make available to those patients, and their relatives, such written
statements of their rights and powers under this Act as may be so prescribed; and
(d) for the determination in accordance with the regulations of the age of any person
whose exact age cannot be ascertained by reference to the registers kept under the
Births and Deaths Registration Act 1953; and
(e) for enabling the functions under this Part of this Act of the nearest relative of a
patient to be performed, in such circumstances and subject to such conditions (if any)
as may be prescribed by the regulations, by any person authorised in that behalf by
that relative;
and for the purposes of this Part of this Act any application, report or notice the service
of which is regulated under paragraph (b) above shall be deemed to have been received
by or furnished to the authority or person to whom it is authorised or required to be
furnished, addressed or given if it is duly served in accordance with the regulations.
(3) Without prejudice to subsections (1) and (2) above, but subject to section 23(4) and (6)
above, regulations under this section may determine the manner in which functions under
this Part of this Act of the managers of hospitals, local social services authorities, Local
Health Board , Special Health Authorities, National Health Service trusts or NHS

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foundation trusts are to be exercised, and such regulations may in particular specify the
circumstances in which, and the conditions subject to which, any such functions may be
performed by officers of or other persons acting on behalf of those managers, boards,
authorities and trusts.

33. Special provisions as to wards of court.
(1) An application for the admission to hospital of a minor who is a ward of court may be
made under this Part of this Act with the leave of the court; and section 11(4) above shall
not apply in relation to an application so made.
(2) Where a minor who is a ward of court is liable to be detained in a hospital by virtue of
an application for admission under this Part of this Act, any power exercisable under this
Part of this Act or is a community patient or under section 66 below in relation to the
patient by his nominated person nearest relative shall be exercisable by or with the leave
of the court.
(3) Nothing in this Part of this Act shall be construed as authorising the making of a
guardianship application in respect of a minor who is a ward of court, or the transfer into
guardianship of any such minor.
(4) Where a community treatment order has been made in respect of a minor who is a
ward of court, the provisions of this Part of this Act relating to community treatment
orders and community patients have effect in relation to the minor subject to any order
which the court makes in the exercise of its wardship jurisdiction; but this does not apply
as regards any period when the minor is recalled to hospital under section 17E above.

34. Interpretation of Part II.
(1) In this Part of this Act—
“the appropriate practitioner” means–
(a) in the case of a patient who is subject to the guardianship of a person other than a
local social services authority, the nominated medical attendant of the patient; and
(b) in any other case, the responsible clinician;

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“the community clinician” means—
(a) in relation to a patient who is liable to be detained in a hospital in pursuance of
an application for admission for treatment, the approved clinician who would
oversee the patient’s care if they were to become a community patient;

(b) in relation to a community patient, the approved clinician overseeing the
patient’s care as a community patient;
“the nominated medical attendant” , in relation to a patient who is subject to the
guardianship of a person other than a local social services authority, means the person
appointed in pursuance of regulations made under section 9(2) above to act as the
medical attendant of the patient;
“registered establishment” means an establishment which would not, apart from
subsection (2) below, be a hospital for the purposes of this Part and which—
(a) in England, is a hospital as defined by section 275 of the National Health Service
Act 2006 that is used for the carrying on of a regulated activity, within the meaning
of Part 1 of the Health and Social Care Act 2008, which relates to the assessment or
medical treatment of mental disorder and in respect of which a person is
registered under Chapter 2 of that Part; and
(b) in Wales, is an establishment in respect of which a person is registered under Part 2
of the Care Standards Act 2000 as an independent hospital in which treatment or
nursing (or both) are provided for persons liable to be detained under this Act;
“the relevant hospital” means—
(a) in relation to a patient who is liable to be detained in a hospital, that hospital;
(b) in relation to a community patient, the responsible hospital;
“the responsible clinician” means–
(a) in relation to a patient liable to be detained by virtue of an application for
admission for assessment or an application for admission for treatment, or a
community patient, the approved clinician nominated by the managers of the
relevant hospital to have with overall responsibility for the patient's case;

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(b) in relation to a patient subject to guardianship, the approved clinician authorised
by the responsible local social services authority to act (either generally or in any
particular case or for any particular purpose) as the responsible clinician
(2) Except where otherwise expressly provided, this Part of this Act applies in relation to a
registered establishment, as it applies in relation to a hospital, and references in this Part
of this Act to a hospital, and any reference in this Act to a hospital to which this Part of this
Act applies, shall be construed accordingly.
(3) In relation to a patient who is subject to guardianship in pursuance of a guardianship
application, any reference in this Part of this Act to the responsible local social services
authority is a reference—
(a) where the patient is subject to the guardianship of a local social services authority,
to that authority;
(b) where the patient is subject to the guardianship of a person other than a local
social services authority, to the local social services authority for the area in which
that person resides.

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Part III
PATIENTS CONCERNED IN CRIMINAL PROCEEDINGS OR UNDER SENTENCE
Application of Part 3: “relevant disorder”
34A Application of Part 3: “relevant disorder”
In this Part “relevant disorder” means—
(a) psychiatric disorder,
(b) autism, or
(c) learning disability which has serious behavioural consequences.

Remands to hospital
35. Remand to hospital for report on accused's mental condition.
(1) Subject to the provisions of this section, the Crown Court or a magistrates' court may
remand an accused person to a hospital specified by the court for a report on his mental
condition.
(2) For the purposes of this section an accused person is—
(a) in relation to the Crown Court, any person who is awaiting trial before the court for
an offence punishable with imprisonment or who has been arraigned before the court
for such an offence and has not yet been sentenced or otherwise dealt with for the
offence on which he has been arraigned;
(b) in relation to a magistrates’ court, any person who has been convicted by the court
of an offence punishable on summary conviction with imprisonment and any person
charged with such an offence if the court is satisfied that he did the act or made the
omission charged or he has consented to the exercise by the court of the powers
conferred by this section.

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(3) Subject to subsection (4) below, the powers conferred by this section may be
exercised if—
(a) the court is satisfied, on the written or oral evidence of a registered medical
practitioner, that there is reason to suspect that the accused person is suffering
from relevant mental disorder ; and
(b) the court is of the opinion that it would be impracticable for a report on his mental
condition to be made if he were remanded on bail;
but those powers shall not be exercised by the Crown Court in respect of a person who
has been convicted before the court if the sentence for the offence of which he has
been convicted is fixed by law.
(4) The court shall not remand an accused person to a hospital under this section unless
satisfied, on the written or oral evidence of the approved clinician who would be
responsible for making the report or of some other person representing the managers of
the hospital, that arrangements have been made for his admission to that hospital and for
his admission to it within the period of seven days beginning with the date of the remand;
and if the court is so satisfied it may, pending his admission, give directions for his
conveyance to and detention in a place of safety.
(5) Where a court has remanded an accused person under this section it may further
remand him if it appears to the court, on the written or oral evidence of the approved
clinician responsible for making the report, that a further remand is necessary for
completing the assessment of the accused person's mental condition.
(6) The power of further remanding an accused person under this section may be
exercised by the court without his being brought before the court if he is represented by
an authorised person who is given an opportunity of being heard.
(7) An accused person shall not be remanded or further remanded under this section for
more than 28 days at a time or for more than 12 weeks in all; and the court may at any
time terminate the remand if it appears to the court that it is appropriate to do so.
(8) An accused person remanded to hospital under this section shall be entitled to obtain
at his own expense an independent report on his mental condition from a registered
medical practitioner or approved clinician chosen by him and to apply to the court on the
basis of it for his remand to be terminated under subsection (7) above.
(9) Where an accused person is remanded under this section—

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(a) a constable or any other person directed to do so by the court shall convey the
accused person to the hospital specified by the court within the period mentioned in
subsection (4) above; and
(b) the managers of the hospital shall admit him within that period and thereafter
detain him in accordance with the provisions of this section.
(10) If an accused person absconds from a hospital to which he has been remanded under
this section, or while being conveyed to or from that hospital, he may be arrested without
warrant by any constable and shall, after being arrested, be brought as soon as
practicable before the court that remanded him; and the court may thereupon terminate
the remand and deal with him in any way in which it could have dealt with him if he had
not been remanded under this section.

36. Remand of accused person to hospital for treatment.
(1) Subject to the provisions of this section, the Crown Court may, instead of remanding an
accused person in custody, remand him to a hospital specified by the court if satisfied, on
the written or oral evidence of two registered medical practitioners, that
(a) he is suffering from relevant mental disorder of a nature or degree which makes it
appropriate for him to be detained in a hospital for medical treatment; and
(b) appropriate medical treatment is available for him.
(2) For the purposes of this section an accused person is any person who is in custody
awaiting trial before the Crown Court for an offence punishable with imprisonment (other
than an offence the sentence for which is fixed by law) or who at any time before sentence
is in custody in the course of a trial before that court for such an offence.
(3) The court shall not remand an accused person under this section to a hospital unless it
is satisfied, on the written or oral evidence of the approved clinician who would be
nominated by the managers of the hospital to have overall responsibility for his case or of
some other person representing the managers of the hospital, that arrangements have
been made for his admission to that hospital and for his admission to it within the period
of seven days beginning with the date of the remand; and if the court is so satisfied it may,
pending his admission, give directions for his conveyance to and detention in a place of
safety.

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(4) Where a court has remanded an accused person under this section it may further
remand him if it appears to the court, on the written or oral evidence of the responsible
clinician, that a further remand is warranted
(5) The power of further remanding an accused person under this section may be
exercised by the court without his being brought before the court if he is represented
by an authorised person who is given an opportunity of being heard.
(6) An accused person shall not be remanded or further remanded under this section for
more than 28 days at a time or for more than 12 weeks in all; and the court may at any
time terminate the remand if it appears to the court that it is appropriate to do so.
(7) An accused person remanded to hospital under this section shall be entitled to obtain
at his own expense an independent report on his mental condition from a registered
medical practitioner or approved clinician chosen by him and to apply to the court on the
basis of it for his remand to be terminated under subsection (6) above.
(8) Subsections (9) and (10) of section 35 above shall have effect in relation to a remand
under this section as they have effect in relation to a remand under that section.

36A. Remands to hospital: nominated person
Sections 30A and 30B and Schedule A1 (nominated person) apply in relation to a person
remanded to hospital under section 35 or 36 as they apply in relation to a person subject
to an order under section 41 (see section 41(3) and Part 2 of Schedule 1).

Hospital and guardianship orders
37. Powers of courts to order hospital admission or guardianship.
(1) Where a person is convicted before the Crown Court of an offence punishable with
imprisonment other than an offence the sentence for which is fixed by law, or is convicted
by a magistrates' court of an offence punishable on summary conviction with
imprisonment, and the conditions mentioned in subsection (2) below are satisfied, the
court may by order authorise his admission to and detention in such hospital as may be
specified in the order or, as the case may be, place him under the guardianship of a local

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social services authority or of such other person approved by a local social services
authority as may be so specified.
(1A) In the case of an offence the sentence for which would otherwise fall to be imposed
under section 258, 268A, 273, 274, 282A, 283 or 285 of the Sentencing Code or under
Chapter 7 of Part 10 of that Code, nothing in those provisions shall prevent a court from
making an order under subsection (1) above for the admission of the offender to a
hospital.
(1B) For the purposes of subsection (1A) above—
(a) a sentence falls to be imposed under section 258 of the Sentencing Code if the court
is obliged by that section to pass a sentence of detention for life under section 250 of
that Code;
(aa) a sentence falls to be imposed under section 268A or 282A of that Code if it is
required by section 268B(2) or 282B(2) of that Code and the court is not of the opinion
there mentioned;
(b) a sentence falls to be imposed under section 273 or 274 of that Code if the court is
obliged by that section to pass a sentence of custody for life;
(c) a sentence falls to be imposed under section 283 or 285 of that Code if the court is
obliged by that section to pass a sentence of imprisonment for life;
(d) a sentence falls to be imposed under Chapter 7 of Part 10 of that Code if it is
required by section 311(2), 312(2), 313(2), 314(2) or 315(2) of that Code and the court is
not of the opinion there mentioned.
(2) The conditions referred to in subsection (1) above are that—
(a) the court is satisfied, on the written or oral evidence of two registered medical
practitioners, that the offender is suffering from relevant mental disorder and that
either—
(i) the relevant mental disorder from which the offender is suffering is of a nature
or degree which makes it appropriate for him to be detained in a hospital for
medical treatment and appropriate medical treatment is available for him; o

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(ii) in the case of an offender who has attained the age of 16 years, the relevant
mental disorder is of a nature or degree which warrants his reception into
guardianship under this Act; and
(b) the court is of the opinion, having regard to all the circumstances including the
nature of the offence and the character and antecedents of the offender, and to the
other available methods of dealing with him, that the most suitable method of
disposing of the case is by means of an order under this section.
(3) Where a person is charged before a magistrates' court with any act or omission as an
offence and the court would have power, on convicting him of that offence, to make an
order under subsection (1) above in his case, then, if the court is satisfied that the accused
did the act or made the omission charged, the court may, if it thinks fit, make such an
order without convicting him.
(4) An order for the admission of an offender to a hospital (in this Act referred to as “a
hospital order”) shall not be made under this section unless the court is satisfied on the
written or oral evidence of the approved clinician who would be nominated by the
managers of the hospital to have overall responsibility for his case or of some other
person representing the managers of the hospital that arrangements have been made for
his admission to that hospital, and for his admission to it within the period of 28 days
beginning with the date of the making of such an order; and the court may, pending his
admission within that period, given such directions as it thinks fit for his conveyance to
and detention in a place of safety.
(5) If within the said period of 28 days it appears to the Secretary of State that by reason of
an emergency or other special circumstances it is not practicable for the patient to be
received into the hospital specified in the order, he may give directions for the admission
of the patient to such other hospital as appears to be appropriate instead of the hospital
so specified; and where such directions are given—
(a) the Secretary of State shall cause the person having the custody of the patient to be
informed, and
(b) the hospital order shall have effect as if the hospital specified in the directions were
substituted for the hospital specified in the order.
(6) An order placing an offender under the guardianship of a local social services authority
or of any other person (in this Act referred to as “a guardianship order”) shall not be made

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under this section unless the court is satisfied that that authority or person is willing to
receive the offender into guardianship.
(8) Where an order is made under this section, the court shall not—
(a) pass sentence of imprisonment or impose a fine or make a community order
(within the meaning given by section 200 of the Sentencing Code or a youth
rehabilitation order (within the meaning given by section 173 of that Code) in respect of
the offence,
(b) if the order under this section is a hospital order, make a referral order (within the
meaning given by section 83 of that Code) in respect of the offence, or
(c) make in respect of the offender an order under section 376 of that Code (binding
over of parent or guardian),
but the court may make any other order which it has power to make apart from this
section; and for the purposes of this subsection “sentence of imprisonment” includes
any sentence or order for detention.

38. Interim hospital orders.
(1) Where a person is convicted before the Crown Court of an offence punishable with
imprisonment (other than an offence the sentence for which is fixed by law) or is
convicted by a magistrates' court of an offence punishable on summary conviction with
imprisonment and the court before or by which he is convicted is satisfied, on the written
or oral evidence of two registered medical practitioners—
(a) that the offender is suffering from relevant mental disorder ; and
(b) that there is reason to suppose that the relevant mental disorder from which the
offender is suffering is such that it may be appropriate for a hospital order to be made
in his case,
the court may, before making a hospital order or dealing with him in some other way,
make an order (in this Act referred to as “an interim hospital order”) authorising his
admission to such hospital as may be specified in the order and his detention there in
accordance with this section.

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(2) In the case of an offender who is subject to an interim hospital order the court may
make a hospital order without his being brought before the court if he is represented
by [an authorised person who]2 is given an opportunity of being heard.
(3) At least one of the registered medical practitioners whose evidence is taken into
account under subsection (1) above shall be employed at the hospital which is to be
specified in the order.
(4) An interim hospital order shall not be made for the admission of an offender to a
hospital unless the court is satisfied, on the written or oral evidence of the approved
clinician who would be nominated by the managers of the hospital to have overall
responsibility for his case or of some other person representing the managers of the
hospital, that arrangements have been made for his admission to that hospital and for his
admission to it within the period of 28 days beginning with the date of the order; and if the
court is so satisfied the court may, pending his admission, given directions for his
conveyance to and detention in a place of safety.
(5) An interim hospital order—
(a) shall be in force for such period, not exceeding 12 weeks, as the court may specify
when making the order; but
(b) may be renewed for further periods of not more than 28 days at a time if it appears
to the court, on the written or oral evidence of the responsible clinician , that the
continuation of the order is warranted but no such order shall continue in force for
more than twelve months in all and the court shall terminate the order if it makes a
hospital order in respect of the offender or decides after considering the written or
oral evidence of the [responsible clinician]4 to deal with the offender in some other
way.
(6) The power of renewing an interim hospital order may be exercised without the
offender being brought before the court if he is represented by counsel or a solicitor and
his counsel or solicitor is given an opportunity of being heard.
(7) If an offender absconds from a hospital in which he is detained in pursuance of an
interim hospital order, or while being conveyed to or from such a hospital, he may be
arrested without warrant by a constable and shall, after being arrested, be brought as
soon as practicable before the court that made the order; and the court may thereupon
terminate the order and deal with him in any way in which it could have dealt with him if
no such order had been made.

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(8) Sections 30A and 30B and Schedule A1 (nominated person) apply in relation to an
offender subject to an interim hospital order as they apply in relation to a person subject
to an order under section 41 (see section 41(3) and Part 2 of Schedule 1).

39. Information as to hospitals.
(1) Where a court is minded to make a hospital order or interim hospital order in respect of
any person it may request—
(a) the integrated care board…Local Health Board for the area in which that person
resides or last resided; or
(b) NHS England or the National Assembly for Wales or any other integrated care
board...Local Health Board that appears to the court to be appropriate,
to furnish the court with such information as that integrated care board…Local Health
Board or NHS England or the National Assembly for Wales have or can reasonably obtain
with respect to the hospital or hospitals (if any) in their area or elsewhere at which
arrangements could be made for the admission of that person in pursuance of the order,
and that integrated care board... Local Health Board or NHS England or the National
Assembly for Wales shall comply with any such request.
(1ZA) A request under this section to NHS England may relate only to services or facilities
the provision of which NHS England arranges.
(1A) In relation to a person who has not attained the age of 18 years, subsection (1) above
shall have effect as if the reference to the making of a hospital order included a reference
to a remand under section 35 or 36 above or the making of an order under section 44
below.
(1B) Where the person concerned has not attained the age of 18 years, the information
which may be requested under subsection (1) above includes, in particular, information
about the availability of accommodation or facilities designed so as to be specially
suitable for patients who have not attained the age of 18 years.
(2) [Repealed by the Health Authorities Act 1995]

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39A. Information to facilitate guardianship orders.
Where a court is minded to make a guardianship order in respect of any offender, it may
request the local social services authority for the area in which the offender resides or last
resided, or any other local social services authority that appears to the court to be
appropriate—
(a) to inform the court whether it or any other person approved by it is willing to receive
the offender into guardianship; and
(b) if so, to give such information as it reasonably can about how it or the other person
could be expected to exercise in relation to the offender the powers conferred by
section 40(2) below;
and that authority shall comply with any such request.

40. Effect of hospital orders, guardianship orders and interim hospital orders.
(1) A hospital order shall be sufficient authority—
(a) for a constable, an approved mental health professional or any other person
directed to do so by the court to convey the patient to the hospital specified in the
order within a period of 28 days; and
(b) for the managers of the hospital to admit him at any time within that period and
thereafter detain him in accordance with the provisions of this Act.
(2) A guardianship order shall confer on the authority or person named in the order as
guardian the same powers as a guardianship application made and accepted under Part II
of this Act.
(3) Where an interim hospital order is made in respect of an offender—
(a) a constable or any other person directed to do so by the court shall convey the
offender to the hospital specified in the order within the period mentioned in section
38(4) above; and
(b) the managers of the hospital shall admit him within that period and thereafter
detain him in accordance with the provisions of section 38 above.

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(4) A patient who is admitted to a hospital in pursuance of a hospital order, or placed
under guardianship by a guardianship order, shall, subject to the provisions of this
subsection, be treated for the purposes of the provisions of this Act mentioned in Part I of
Schedule 1 to this Act as if he had been so admitted or placed on the date of the order in
pursuance of an application for admission for treatment or a guardianship application, as
the case may be, duly made under Part II of this Act, but subject to any modifications of
those provisions specified in that Part of that Schedule.
(5) Where a patient is admitted to a hospital in pursuance of a hospital order, or placed
under guardianship by a guardianship order, any previous application, hospital order or
guardianship order by virtue of which he was liable to be detained in a hospital or subject
to guardianship shall cease to have effect; but if the first-mentioned order, or the
conviction on which it was made, is quashed on appeal, this subsection shall not apply
and section 22 above shall have effect as if during any period for which the patient was
liable to be detained or subject to guardianship under the order, he had been detained in
custody as mentioned in that section.
(6) Where—
(a) a patient admitted to a hospital in pursuance of a hospital order is absent without
leave;
(b) a warrant to arrest him has been issued under section 72 of the M1Criminal Justice
Act 1967; and
(c) he is held pursuant to the warrant in any country or territory other than the United
Kingdom, any of the Channel Islands and the Isle of Man,
he shall be treated as having been taken into custody under section 18 above on first
being so held.

Restriction orders
41. Power of higher courts to restrict discharge from hospital.
(1) Where a hospital order is made in respect of an offender by the Crown Court, and it
appears to the court, having regard to the nature of the offence, the antecedents of the
offender and the risk of his committing further offences if set at large, that it is necessary
for the protection of the public from serious harm so to do, the court may, subject to the

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provisions of this section, further order that the offender shall be subject to the special
restrictions set out in this section; and an order under this section shall be known as “a
restriction order”.
(2) A restriction order shall not be made in the case of any person unless at least one of the
registered medical practitioners whose evidence is taken into account by the court under
section 37(2)(a) above has given evidence orally before the court.
(3) The special restrictions applicable to a patient in respect of whom a restriction order is
in force are as follows—
(a) none of the provisions of Part II of this Act relating to the duration, renewal and
expiration of authority for the detention of patients shall apply, and the patient shall
continue to be liable to be detained by virtue of the relevant hospital order until he is
duly discharged under the said Part II or absolutely discharged under section 42, 73, 74
or 75 below;
(aa) none of the provisions of Part II of this Act relating to community treatment orders
and community patients shall apply;
(b) no application shall be made to the appropriate tribunal in respect of a patient
under section 66 or 69(1) below;
(c) the following powers shall be exercisable only with the consent of the Secretary of
State, namely—
(i) power to grant leave of absence to the patient under section 17 above;
(ii) power to transfer the patient in pursuance of regulations under section 19
above or in pursuance of subsection 3 of that section; and
(iii) power to order the discharge of the patient under section 23 above;
and if leave of absence is granted under the said section 17 power to recall the patient
under that section shall vest in the Secretary of State as well as the responsible
clinician; and
(d) the power of the Secretary of State to recall the patient under the said section 17
and power to take the patient into custody and return him under section 18 above may
be exercised at any time;

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and in relation to any such patient section 40(4) above shall have effect as if it referred to
Part II of Schedule 1 to this Act instead of Part I of that Schedule.
(4) A hospital order shall not cease to have effect under section 40(5) above if a restriction
order in respect of the patient is in force at the material time.
(5) Where a restriction order in respect of a patient ceases to have effect while the relevant
hospital order continues in force, the provisions of section 40 above and Part I of Schedule
1 to this Act shall apply to the patient as if he had been admitted to the hospital in
pursuance of a hospital order (without a restriction order) made on the date on which the
restriction order ceased to have effect.
(6) While a person is subject to a restriction order the responsible clinician shall at such
intervals (not exceeding one year) as the Secretary of State may direct examine and report
to the Secretary of State on that person; and every report shall contain such particulars as
the Secretary of State may require.

42. Powers of Secretary of State in respect of patients subject to restriction
orders.
(1) If the Secretary of State is satisfied that in the case of any patient a restriction order is
no longer required for the protection of the public from serious harm, he may direct that
the patient shall cease to be subject to the special restrictions set out in section
41(3) above; and where the Secretary of State so directs, the restriction order shall cease
to have effect, and section 41(5) above shall apply accordingly.
(2) At any time while a restriction order is in force in respect of a patient, the Secretary of
State may, if he thinks fit, by warrant discharge the patient from hospital, either
absolutely or subject to conditions; and where a person is absolutely discharged under
this subsection, he shall thereupon cease to be liable to be detained by virtue of the
relevant hospital order, and the restriction order shall cease to have effect accordingly.
(2A) Conditions amounting to a deprivation of a patient’s liberty may be imposed under
subsection (2) if the Secretary of State is satisfied that those conditions are necessary for
the protection of the public from serious harm.
(3) The Secretary of State may at any time during the continuance in force of a restriction
order in respect of a patient who has been conditionally discharged under subsection (2)
above by warrant recall the patient to such hospital as may be specified in the warrant.

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(4) Where a patient is recalled as mentioned in subsection (3) above—
(a) if the hospital specified in the warrant is not the hospital from which the patient
was conditionally discharged, the hospital order and the restriction order shall have
effect as if the hospital specified in the warrant were substituted for the hospital
specified in the hospital order;
(b) in any case, the patient shall be treated for the purposes of section 18 above as if he
had absented himself without leave from the hospital specified in the warrant .
(5) If a restriction order in respect of a patient ceases to have effect after the patient has
been conditionally discharged under this section, the patient shall, unless previously
recalled under subsection (3) above, be deemed to be absolutely discharged on the date
when the order ceases to have effect, and shall cease to be liable to be detained by virtue
of the relevant hospital order accordingly.
(6) The Secretary of State may, if satisfied that the attendance at any place in Great
Britain of a patient who is subject to a restriction order is desirable in the interests of
justice or for the purposes of any public inquiry, direct him to be taken to that place; and
where a patient is directed under this subsection to be taken to any place he shall, unless
the Secretary of State otherwise directs, be kept in custody while being so taken, while at
that place and while being taken back to the hospital in which he is liable to be detained.
43. Power of magistrates’ courts to commit for restriction order.
(1) If in the case of a person of or over the age of 14 years who is convicted by a
magistrates’ court of an offence punishable on summary conviction with imprisonment—
(a) the conditions which under section 37(1) above are required to be satisfied for the
making of a hospital order are satisfied in respect of the offender; but
(b) it appears to the court, having regard to the nature of the offence, the antecedents
of the offender and the risk of his committing further offences if set at large, that if a
hospital order is made a restriction order should also be made,
the court may, instead of making a hospital order or dealing with him in any other
manner, commit him in custody to the Crown Court to be dealt with in respect of the
offence.
(2) Where an offender is committed to the Crown Court under this section, the Crown
Court shall inquire into the circumstances of the case and may—

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(a) if that court would have power so to do under the foregoing provisions of this Part of
this Act upon the conviction of the offender before that court of such an offence as is
described in section 37(1) above, make a hospital order in his case, with or without a
restriction order;
(b )if the court does not make such an order, deal with the offender in any other
manner in which the magistrates’ court might have dealt with him.
(3) The Crown Court shall have the same power to make orders under sections 35, 36 and
38 above in the case of a person committed to the court under this section as the Crown
Court has under those sections in the case of an accused person within the meaning of
section 35 or 36 above or of a person convicted before that court as mentioned in section
38 above.
(4) The powers of a magistrates' court under section 14, 16 or 16A of the Sentencing
Code (which enable such a court to commit an offender to the Crown Court where the
court is of the opinion, or it appears to the court, as mentioned in the section in question)
shall also be exercisable by a magistrates' court where it is of that opinion (or it so appears
to it) unless a hospital order is made in the offender’s case with a restriction order.
(5) The power of the Crown Court to make a hospital order, with or without a restriction
order, in the case of a person convicted before that court of an offence may, in the same
circumstances and subject to the same conditions, be exercised by such a court in the
case of a person committed to the court under section 5 of the Vagrancy Act 1824 (which
provides for the committal to the Crown Court of persons who are incorrigible rogues
within the meaning of that section).

44. Committal to hospital under s. 43.
(1) Where an offender is committed under section 43(1) above and the magistrates' court
by which he is committed is satisfied on written or oral evidence that arrangements have
been made for the admission of the offender to a hospital in the event of an order being
made under this section, the court may, instead of committing him in custody, by order
direct him to be admitted to that hospital, specifying it, and to be detained there until the
case is disposed of by the Crown Court, and may give such directions as it thinks fit for his
production from the hospital to attend the Crown Court by which his case is to be dealt
with.

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(2) The evidence required by subsection (1) above shall be given by the approved clinician
who would be nominated by the managers of the hospital to have overall responsibility
for the offender's case or by some other person representing the managers of the hospital
in question.
(3) The power to give directions under section 37(4) above, section 37(5) above and
section 40(1) above shall apply in relation to an order under this section as they apply in
relation to a hospital order, but as if references to the period of 28 days mentioned in
section 40(1) above were omitted; and subject as aforesaid an order under this section
shall, until the offender's case is disposed of by the Crown Court, have the same effect as a
hospital order together with a restriction order.

45. Appeals from magistrates’ courts.
(1) Where on the trial of an information charging a person with an offence a magistrates’
court makes a hospital order or guardianship order in respect of him without convicting
him, he shall have the same right of appeal against the order as if it had been made on his
conviction; and on any such appeal the Crown Court shall have the same powers as if the
appeal had been against both conviction and sentence.
(2) An appeal by a child or young person with respect to whom any such order has been
made, whether the appeal is against the order or against the finding upon which the order
was made, may be brought by him or by his parent or guardian on his behalf

Hospital and limitation directions
45A. Power of higher courts to direct hospital admission.
(1) This section applies where, in the case of a person convicted before the Crown Court of
an offence the sentence for which is not fixed by law—
(a) the conditions mentioned in subsection (2) below are fulfilled; and
(b) the court considers making a hospital order in respect of him before deciding to
impose a sentence of imprisonment (“the relevant sentence”) in respect of the offence.
(2) The conditions referred to in subsection (1) above are that the court is satisfied, on the
written or oral evidence of two registered medical practitioners—

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(a) that the offender is suffering from relevant mental disorder;
(b) that the relevant mental disorder from which the offender is suffering is of a nature
or degree which makes it appropriate for him to be detained in a hospital for medical
treatment; and
(c) that appropriate medical treatment is available for him.
(3) The court may give both of the following directions, namely—
(a) a direction that, instead of being removed to and detained in a prison, the offender
be removed to and detained in such hospital as may be specified in the direction (in
this Act referred to as a “hospital direction” ); and
(b) a direction that the offender be subject to the special restrictions set out in section
41 above (in this Act referred to as a “limitation direction” ).
(4) A hospital direction and a limitation direction shall not be given in relation to an
offender unless at least one of the medical practitioners whose evidence is taken into
account by the court under subsection (2) above has given evidence orally before the
court.
(5) A hospital direction and a limitation direction shall not be given in relation to an
offender unless the court is satisfied on the written or oral evidence of the approved
clinician who would be nominated by the managers of the hospital to have overall
responsibility for his case, or of some other person representing the managers of the
hospital that arrangements have been made—
(a) for his admission to that hospital; and
(b) for his admission to it within the period of 28 days beginning with the day of the
giving of such directions;
and the court may, pending his admission within that period, give such directions as it
thinks fit for his conveyance to and detention in a place of safety.
(6) If within the said period of 28 days it appears to the Secretary of State that by reason of
an emergency or other special circumstances it is not practicable for the patient to be
received into the hospital specified in the hospital direction, he may give instructions for
the admission of the patient to such other hospital as appears to be appropriate instead of
the hospital so specified.

Document details

Type

Bill

Published

2 Oct 2025

Responsible body

Department of Health and Social Care

Issue

Mental Health Act 2025

Provenance

Linked to "Mental Health Act 2025" via bill_publication (confidence 1.00) · verified

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